Urinary Incontinence Drugs Have Comparable Efficacy
(HealthDay News) – Available pharmacotherapies for treating women with urinary incontinence (UI) produce comparable small benefits.
Tatyana Shamliyan, MD, of the University of Minnesota School of Public Health in Minneapolis, and colleagues conducted a systematic review and identified 94 English-language randomized controlled trials published between 1966–November 2011 to evaluate the benefits and harms of pharmacological treatment for UI in women. Response to treatment was defined as a >50% reduction in daily UI episodes. This review, which was funded by the Agency for Healthcare Research and Quality (AHRQ), was intended to support the development of an American College of Physicians clinical practice guideline on the treatment of UI.
The researchers found that urinary continence after drug treatment was highest for women treated with fesoterodine (130 per 1,000 women treated), followed by oxybutynin (114), trospium (114), solifenacin (107), and tolterodine (85). Discontinuation rates due to adverse events were highest for oxybutynin (63 per 1,000 women treated), followed by fesoterodine (31), trospium (18), and solifenacin (13). Significant inconsistencies in the definition of improvement in UI and quality of life; a lack of evidence regarding long-term safety and adherence to treatment; and limited evidence regarding the effects of race, comorbidities, or baseline severity of UI, complicated the analysis of benefits and harms associated with these drugs.
"Since all drugs for urgency UI have comparable effectiveness, therapeutic choices should consider the harms profile, and women should be informed about all possible adverse effects," the authors write.