Update on overactive bladder: Pharmacologic approaches on the horizon
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Limitations exist with regard to the array of available agents for the pharmacologic therapy of overactive bladder, including issues of efficacy and tolerability. It is clear that the ideal agent for this condition has not been identified. However, several new pharmacologic treatments, including some with novel approaches to drug delivery, have emerged in clinical development over the past few years. These agents include a variety of anticholinergics and others. In initial studies, some of the agents appear to compare favorably with existing therapies. Whether these promising results will hold up when subjected to large-scale, well-controlled clinical trials is unclear.
- Diokno AC, Lapides J: Oxybutynin: a new drug with analgesic and anticholinergic properties. J Urol 1972, 108:307–309.
- Rovner ES, Wein AJ: Modern pharmacotherapy of urge urinary incontinence in the U.S.: tolterodine and oxybutynin. Br J Urol 2000, 86:44–54.
- Wein AJ: Neuromuscular dysfunction of the lower urinary tract and its management. In Campbell’s Urology, edn 8. Edited by Walsh PC, Retik A, Vaughan ED Jr, et al. Philadelphia: WB Saunders; 2002.
- Andersson KE, Appell RA, Cardozo L, et al.: Pharmacological treatment of urinary incontinence. In Incontinence. Edited by Abrams P, Khoury S, Wein AJ. Plymouth, UK: Heath Publication Ltd; 1999:447–486.
- Hay-Smith J, Herbison P, Ellis G, Moore K: Anticholinergic drugs versus placebo for overactive bladder syndrome in adults. Cochrane Database Syst Rev 2002, 3:CD003781.
- Yoshimura N, Chancellor MB: Current and future pharmacological treatment for overactive bladder. J Urol 2002, 168:1897–1913. This is a comprehensive review of many of the preclinical and clinical studies of potential pharmacologic therapies for overactive bladder. Included is an interesting discussion of future (theoretical) potential advances, including gene therapy. CrossRef
- Sellers DJ, Chapple CR, Chess-Williams R: Potential therapeutic targets for treatment of the overactive bladder. World J Urol 2001, 19:307–311. CrossRef
- Rovner ES, Wein AJ: Once-daily, extended-release formulations of antimuscarinic agents in the treatment of overactive bladder: a review. Eur Urol 2002, 41:6–14. CrossRef
- Van Kerrebroeck P, Kreder K, Jonas U, et al.: Tolterodine oncedaily: superior efficacy and tolerability in the treatment of the overactive bladder. Urology 2001, 57:414–421. CrossRef
- Anderson RU, Mobley D, Blank B, et al.: Once-daily controlled versus immediate-release oxybutynin chloride for urge incontinence. J Urol 1999, 16:1809–1812.
- Gupta SK, Sathyan G: Pharmacokinetics of an oral once-a-day controlled-release oxybutynin formulation compared with immediate-release oxybutynin. J Clin Pharmacol 1999, 39:289–296.
- Buyse G, Waldeck K, Verpoorten C, et al.: Intravesical oxybutynin for neurogenic bladder dysfunction: less systemic side effects due to reduced first pass metabolism. J Urol 1998, 160:892–896. CrossRef
- Hughes KM, Lang JC, Lazare R, et al.: Measurement of oxybutynin and its N-desethyl metabolite in plasma, and its application to pharmacokinetic studies in young, elderly and frail elderly volunteers. Xenobiotica 1992, 22:859–869.
- Waldeck K, Larsson B, Andersson KE: Comparison of oxybutynin and its active metabolite, N-desethyl-oxybutynin, in the human detrusor and parotid gland. J Urol 1997, 157:1093–1097. CrossRef
- Davila GW, Daugherty CA, Sanders SW, et al.: A short-term, multicenter, randomized, double-blind dose titration study of the efficacy and anticholinergic side effects of transdermal compared to immediate release oral oxybutynin treatment of patients with urge urinary incontinence. J Urol 2001, 166:140–145. Represents the initial peer-reviewed publications on the use of transdermal antimuscarinic therapy for overactive bladder. CrossRef
- Dmochowski RR, Davila GW, Zinner NR, et al.: Efficacy and safety of transdermal oxybutynin in patients with urge and mixed urinary incontinence. J Urol 2002, 168:580–586. Represents the initial peer-reviewed publications on the use of transdermal antimuscarinic therapy for overactive bladder. CrossRef
- Dmochowski R, Davila W, Sanders S: Transdermal oxybutynin and controlled release oral tolterodine in patients with positive treatment effect to anticholinergic therapy for overactive bladder. Neurourol Urodyn 2002, 21:380–381.
- Brendler CB, Radebaugh LC, Mohler JL: Topical oxybutynin chloride for relaxation of dysfunctional bladders. J Urol 1989, 141:1350–1352.
- O’Flynn KJ, Thomas DG: Intravesical instillation of oxybutynin hydrochloride for detrusor hyper-reflexia. Br J Urol 1993, 723:566–570. CrossRef
- Boone TB, Appell RA, Lopez MA, et al.: Pharmacokinetics evaluation of intravesical oxybutynin: bolus and continuous delivery. J Urol 2001, 165:252–253.
- Pietzko A, Dimpfel W, Schwantes U, Topfmeier P: Influences of trospium chloride and oxybutynin on quantitative EEG in healthy volunteers. Eur J Clin Pharmacol 1994, 47:337–343. CrossRef
- Hofner K, Oelke M, Machtens S, Grunewald V: Trospium chloride: an effective drug in the treatment of overactive bladder and detrusor hyper-reflexia. World J Urol 2001, 19:336–343. This is a well-written summary of the up-to-date clinical studies on trospium. CrossRef
- Hawthorn MH, Chapple CR, Cock M, Chess-Williams R: Urothelium-derived inhibitory factor(s) influences on detrusor muscle contractility in vitro. Br J Pharmacol 2000, 129:416–419. CrossRef
- Cardozo L, Chapple CR, Toozs-Hobson P, et al.: Efficacy of trospium chloride in patient with detrusor instability: a placebo-controlled, randomized, double blind, multicentre clinical trial. BJU Int 2000, 85:659–664. CrossRef
- Stohrer M, Bauer P, Giannetti BM, et al.: Effect of trospium chloride on urodynamic parameters n patients with detrusor hyper-reflexia due to spinal cord injuries: a multicentre, placebo-controlled, double-blind trial. Urol Int 1991, 47:138–143. CrossRef
- Alloussi S, Laval KU, Eckert R, et al.: Trospium chloride in a patient with motor urge syndrome (detrusor instability): a double-blind, randomized, multicentre, placebo-controlled study. J Clin Res Drug Dev 1998, 1:439–451.
- Hofner K, Halaska M, Primus G, et al.: Tolerability and efficacy of trospium chloride in a long-term treatment (52 weeks) in patients with urge syndrome: a double-blind, controlled, multicentre clinical trial. Neurourol Urodyn 2000, 19:487–488.
- Donnellan CA, Fook L, McDonald P, Playfer JR: Oxybutynin and cognitive dysfunction. BMJ 1997, 315:1363–1364.
- Katz IR, Sands LP, Bilker W, et al.: Identification of medications that can cause cognitive impairment in older people: the case of oxybutynin chloride. J Am Geriatr Soc 1998, 46:8–13.
- Newgreen DT, Anderson DW, Carter AJ, et al.: Darifenacin: a novel bladder-selective agent for the treatment of urge incontinence. Neurourol Urodyn 1995, 14:555–557.
- Braverman AS, Ruggieri MR, Pontari MA: The M2 muscarinic receptor subtype mediates cholinergic bladder contractions in patients with neurogenic bladder dysfunction. J Urol 2001, 165:36.
- Braverman AS, Tallarida RJ, Ruggieri MR: Interaction between muscarinic receptor subtype signal transduction pathways mediating bladder contraction. Am J Physiol Regul Integr Comp Physiol 2002, 283:1–6.
- Rosario DJ, Cutinha PE, Chapple CR: The effects of single-dose darifenacin on cystometric parameters and salivary flow in patients with urge incontinence secondary to detrusor instability. Eur Urol 1996, 30:240.
- Chapple CR, Arano P, Bosch JH, et al.: YM 905 appears effective and well tolerated in patients with symptomatic idiopathic detrusor overactivity in a European placebo and tolterodine controlled phase II dose finding study. Neurourol Urodyn 2002, 21:381–382.
- Norton P, Zinner N, Yalcin I, et al.: Duloxetine versus placebo in the treatment of stress urinary incontinence. Neurourol Urodyn 2001, 20:532–534.
- MacMahon SB, Spillane K: Brain stem influences on the parasympathetic supply to the urinary bladder of the cat. Brain Res 1982, 234:237–249. CrossRef
- Espey MJ, Downie JW: Serotonergic modulation of cat bladder function before and after spinal transection. Eur J Pharmacol 1995, 287:173–177. CrossRef
- Thor KB, Katofiasc MA: Effects of duloxetine, a combined serotonin and norepinephrine reuptake inhibitor on central neural control of lower urinary tract function in the chloralose-anesthetized female cat. J Pharmacol Exp Ther 1995, 274:1014–1024.
- Zinner N, Dmochowski R, Miklos J, et al.: Duloxetine versus placebo in the treatment of stress urinary incontinence (SUI). Neurourol Urodyn 2002, 21:383–384.
- Schurch B, Stohrer M, Kramer G, et al.: Botulinum-A toxin for treating detrusor hyper-reflexia in spinal cord injured patients: A new alternative to anticholinergic drug? Preliminary report. J Urol 2000, 164:692–697. CrossRef
- Yamaguchi O: _3 Adrenoreceptors in human detrusor muscle. Urology 2002, 59:25–29. CrossRef
- Takeda M, Obara K, Mizusawa T, et al.: Evidence for _3 adrenoceptor subtypes in relaxation of the human urinary bladder detrusor: analysis by molecular biological and pharmacological methods. J Pharmacol Exp Ther 1999, 288:1367–1373.
- Update on overactive bladder: Pharmacologic approaches on the horizon
Current Urology Reports
Volume 4, Issue 5 , pp 385-390
- Cover Date
- Print ISSN
- Online ISSN
- Current Medicine Group
- Additional Links