Efficacy and safety of fesoterodine 8 mg in subjects with overactive bladder after a suboptimal response to tolterodine ER.

Abstract

AIMS:

To assess fesoterodine 8 mg efficacy over time and vs. placebo in subjects with overactive bladder (OAB) who responded suboptimally to tolterodine extended release (ER) 4 mg.

METHODS:

In a 12-week, double-blind trial, subjects with self-reported OAB symptoms for ≥ 6 months, mean of ≥ 8 micturitions and ≥ 2 to < 15 urgency urinary incontinence (UUI) episodes/24 h, and suboptimal response to tolterodine ER 4 mg (defined as ≤ 50% reduction in UUI episodes during 2-week run-in) were randomised to fesoterodine (4 mg for 1 week, 8 mg for 11 weeks) or placebo once daily. Change from baseline to week 12 in UUI episodes (primary end-point) was analysed in step-wise fashion: first, baseline vs. week 12 for fesoterodine; if significant, then change from baseline to week 12 for fesoterodine vs. placebo.

RESULTS:

By week 12, subjects receiving fesoterodine 8 mg had significantly greater improvement from baseline vs. placebo in UUI episodes, urgency episodes and scores on the Patient Perception of Bladder Control, Urgency Perception Scale and OAB Questionnaire Symptom Bother and Health-Related Quality of Life scales and domains (all p < 0.05). 50% and 70% UUI responder rates were also significantly higher with fesoterodine 8 mg vs. placebo at week 12 (p < 0.05). Dry mouth (placebo, 4%, 12/301; fesoterodine, 16.6%, 51/308) and constipation (placebo, 1.3%, 4/301; fesoterodine, 3.9%, 12/308) were the most frequent adverse events.

CONCLUSIONS:

Subjects who responded suboptimally to tolterodine ER 4 mg showed significant improvements in UUI and other OAB symptoms and patient-reported outcomes, with good tolerability, during treatment with fesoterodine 8 mg vs. placebo.

• Authors: S A Kaplan, L Cardozo, S Herschorn, L Grenabo, M Carlsson, D Arumi, T J Crook, L Whelan, D Scholfield, F Ntanios, Assessment of Fesoterodine after Tolterodine ER (AFTER) Study Group
• Journal: International journal of clinical practice (Int J Clin Pract) Vol. 68 Issue 9 Pg. 1065-73 (Sep 2014) ISSN: 1742-1241 [Electronic] India
• PMID: 24898471 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: © 2014 The Authors International Journal of Clinical Practice Published by John Wiley & Sons Ltd.

Chemical References

• Benzhydryl Compounds
• Muscarinic Antagonists
• Tolterodine Tartrate
• fesoterodine

Topics

• Adult
• Aged
• Benzhydryl Compounds (administration & dosage, adverse effects, therapeutic use)
• Double-Blind Method
• Female
• Humans
• Male
• Middle Aged
• Muscarinic Antagonists (administration & dosage, adverse effects, therapeutic use)
• Quality of Life
• Surveys and Questionnaires
• Tolterodine Tartrate (administration & dosage, therapeutic use)
• Treatment Outcome
• Urinary Bladder, Overactive (drug therapy)