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Effectiveness and tolerability of extended-release oxybutynin vs extended-release tolterodine in women with or without prior anticholinergic treatment for overactive bladder

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Abstract

The efficacy and the tolerability of extended-release oxybutynin chloride, 10 mg daily, and extended-release tolterodine tartrate, 4 mg daily, in women with or without prior anticholinergic treatment for overactive bladder (OAB) were compared in a post-hoc analysis of data from the Overactive Bladder: Performance of Extended Release Agents (OPERA) trial. The patient population and study methods have been described previously (Diokno et al., for the OPERA Study Group, Mayo Clin Proc 78:687–695, 2003). Among the group with anticholinergic experience, extended-release oxybutynin was significantly more effective than extended-release tolterodine in reducing micturition frequency at last observation (p=0.052). Complete freedom from urge incontinence was reported by significantly more patients taking oxybutynin than tolterodine at last observation (23.6 vs 15.1%, p=0.038). In addition, among patients completing a full 12 weeks of oxybutynin treatment, significantly greater reductions were observed compared with those taking tolterodine on the primary efficacy variable, number of urge incontinence episodes (p=0.049), and the combined total of urge and non-urge episodes (p=0.012), although the differences between treatment groups were not significant at last observation. In the anticholinergic-naïve group, efficacy and tolerability outcomes were similar across treatments, except that oxybutynin was associated with a significantly lower frequency of micturition at last observation (p=0.035). No efficacy differences favoring tolterodine were observed, and tolerability of the treatments was comparable. Dry mouth (mostly mild to moderate in severity) was reported significantly more often among participants taking extended-release oxybutynin than extended-release tolterodine (32.2 vs 19.2%, p=0.004), but only among those with previous anticholinergic experience. Discontinuation rates were comparably low across groups. The results demonstrate the appropriateness of initiating treatment for OAB with extended-release oxybutynin, particularly in women presenting with incontinence.

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Authors and Affiliations

  1. Department of Urology, Stanford University School of Medicine, 300 Pasteur Drive, Suite 287, Stanford, CA, 94305, USA

    Rodney U. Anderson

  2. Department of Urology, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA

    Scott MacDiarmid

  3. ALZA Corporation, Mountain View, CA, 94043, USA

    Sherron Kell

  4. Department of Surgery, Albany Medical College, Albany, NY, 12206, USA

    James H. Barada

  5. Bladder Control Center of Norwalk, Norwalk, CT, 06880, USA

    Scott Serels

  6. Evanston Continence Center, Northwestern University Medical School, Evanston, IL, 60201, USA

    Roger P. Goldberg

Authors
  1. Rodney U. Anderson
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  2. Scott MacDiarmid
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  3. Sherron Kell
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  4. James H. Barada
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  5. Scott Serels
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  6. Roger P. Goldberg
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Correspondence to Rodney U. Anderson.

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Anderson, R.U., MacDiarmid, S., Kell, S. et al. Effectiveness and tolerability of extended-release oxybutynin vs extended-release tolterodine in women with or without prior anticholinergic treatment for overactive bladder. Int Urogynecol J 17, 502–511 (2006). https://doi.org/10.1007/s00192-005-0057-7

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  • DOI: https://doi.org/10.1007/s00192-005-0057-7

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