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Solifenacin in Overactive Bladder Syndrome

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Abstract

Overactive bladder (OAB) syndrome is a prevalent condition, increasingly recognised as a cause of reduced quality of life that places a substantial economic burden on healthcare provision. While antimuscarinic agents are the therapy of choice for OAB, their use is associated with a number of drawbacks, not least of which is the high rate of adverse events, which is intimately linked with poor compliance with treatment.

Solifenacin succinate is a novel antimuscarinic agent approved in Europe and the US for the treatment of men and women with OAB. The recommended starting dose of solifenacin is 5mg once daily and, if needed, the dose may be increased to 10mg once daily. In multiple clinical trials, solifenacin treatment has been associated with statistically significant reductions in all key symptoms of OAB (notably frequency, urgency and incontinence) as well as increases in volume voided. Solifenacin has been shown to be well tolerated, producing few adverse effects, which are usually mild in nature. Furthermore, possibly because of this favourable efficacy and tolerability, solifenacin treatment has been associated with a high rate of patient persistence with therapy, with 81% of 1802 patients who completed 12-week, double-blind trials enrolling in and completing a 40-week open-label extension study. Solifenacin has been shown to display selectivity for bladder versus salivary tissue in vitro, and studies in healthy men have shown that absorption is slow but extensive with an absolute bioavailability of 88%.

Solifenacin is a well tolerated and efficacious agent for the treatment of OAB, significantly reducing symptoms and improving patients’ quality of life.

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Acknowledgements

This review was undertaken with a grant to provide statistical support and research assistance from Yamanouchi Pharmaceutical Co. Ltd (currently Astellas Pharma Inc.), Tokyo, Japan. Dr Payne currently serves as a consultant to Astellas Pharma Inc. and was on an advisory board during development of solifenacin. He did not receive any personal financial support for preparation of this article.

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Payne, C.K. Solifenacin in Overactive Bladder Syndrome. Drugs 66, 175–190 (2006). https://doi.org/10.2165/00003495-200666020-00004

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