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The role of duloxetine in stress urinary incontinence: a systematic review and meta-analysis

  • Urology - Original Paper
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Abstract

Objectives

This systematic review determined whether the duloxetine can get more benefits versus placebo in managing women with stress urinary incontinence (SUI) all over the world.

Methods

We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing duloxetine with placebo in these patients. The eligible RCTs were identified from the following electronic databases: Cochrane CENTRAL, Medline and EMBASE. We treated the incontinence episode frequency (IEF) as the main outcome, and the secondary outcomes were cured, average voiding interval, incontinence quality of life (I-QOL), treatment-emergent adverse events (TEAEs) and discontinuation.

Results

The review contained ten trials including 5,738 women who were randomized to take duloxetine or placebo. All arms in individual trials were comparable for various baseline characteristics. Individual studies showed a significantly greater decrease in IEF than placebo group. The total IEF responders (defined as a woman who had at least a 50 % decrease in IEF with treatment) within the duloxetine-treated women were more than the placebo-treated women (52.5 vs. 33.7 %; RR = 1.56; 95 %CI, 1.46–1.66; p < 0.00001). TEAEs were commonly experienced by both two groups (62.7 vs. 45.3 %) though they were not critical.

Authors’ conclusions

Our meta-analysis showed that significant efficacy can be found in women treated with a certain dose of duloxetine. The adverse events like nausea, constipation, dry mouth, fatigue etc. are common.

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Abbreviations

SUI:

Stress urinary incontinence

UI:

Urinary incontinence

PFMT:

Pelvic floor muscle training

SNRI:

Serotonin and noradrenaline reuptake inhibitor

IEF:

Incontinence episode frequency

I-QOL:

Incontinence quality of life

TEAEs:

Treatment-emergent adverse events

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Conflict of interest

There was financial support from a grant (National Natural Science Foundation of China (grant 30901484 and 81270841)) for the writing of the review, but none of our co-authors has received financial or travel support or speakers honoraria from any company marketing drugs of devices for overactive bladder.

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Authors and Affiliations

  1. Department of Urology, West China Hospital, Sichuan University, No.37 , Guoxue Xiang, Chengdu, 610041, People’s Republic of China

    Jinhong Li, Lu Yang, Chunxiao Pu, Yin Tang, Haichao Yun & Ping Han

Authors
  1. Jinhong Li
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  2. Lu Yang
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  3. Chunxiao Pu
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  4. Yin Tang
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  5. Haichao Yun
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  6. Ping Han
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Corresponding author

Correspondence to Ping Han.

Additional information

Jinhong Li and Lu Yang were contributed equally to this work and should be considered as co-first author.

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Li, J., Yang, L., Pu, C. et al. The role of duloxetine in stress urinary incontinence: a systematic review and meta-analysis. Int Urol Nephrol 45, 679–686 (2013). https://doi.org/10.1007/s11255-013-0410-6

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  • DOI: https://doi.org/10.1007/s11255-013-0410-6

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