Vidyya Medical News Service
Volume 6 Issue 234 Published - 14:00 UTC 08:00 EST 21-Aug-2004 Next Update - 14:00 UTC 08:00 EST 22-Aug-2004
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Women with mixed incontinence reported a greater benefit for overactive bladder symptoms from tolterodine tartrate than placebo

Women with mixed incontinence, a combination of overactive bladder and stress incontinence, reported a greater treatment benefit for overactive bladder symptoms from Detrol LA (tolterodine tartrate extended release capsules) than placebo, according to new study results published in the August issue of Urology. This is the first study of Detrol LA in women with mixed incontinence, the most common type of urinary incontinence.

There is no treatment for mixed incontinence, so overactive bladder and stress incontinence are treated separately. The symptoms of overactive bladder include urgency (strong, sudden urges to urinate), frequency (often having to go to the bathroom more than eight times in 24 hours which may include getting up at night) and urgency incontinence (wetting accidents accompanied by a sudden and unstoppable urge to urinate). Stress incontinence is leakage of urine in response to activities that increase abdominal pressure, such as coughing, laughing, sneezing or lifting a heavy object.

"For patients with mixed incontinence, urge incontinence is often more bothersome than stress incontinence because it is associated with a greater loss of urine and is more unpredictable," said lead author Dr. Vik Khullar, senior lecturer and consultant urogynecologist in the department of obstetrics and gynecology at St Mary's Hospital, Imperial College, London. "In this study, first-line treatment with Detrol LA significantly improved patients' overactive bladder symptoms in mixed incontinence. Treating overactive bladder first seems justified in women with mixed incontinence, given the profound impact OAB symptoms have on quality of life."

The double blind, randomized, placebo-controlled trial studied women (n=854) who experienced urgency, frequency and at least five episodes of urge incontinence per week in combination with stress incontinence. They received 8 weeks of treatment with Detrol LA or placebo once a day.

Patients treated with Detrol LA experienced a 77 percent reduction in weekly urge incontinence episodes, as compared to 51 percent for those receiving placebo. Patients treated with Detrol LA also reported an overall reduction (37 percent versus 19 percent for placebo) in the number of urgency episodes in a 24-hour period.

After eight weeks, patients treated with Detrol LA were nearly twice (1.9 times) as likely to report an improved bladder condition than patients receiving placebo, and a significantly higher proportion of Detrol LA patients reported that treatment had been beneficial (76 percent versus 55 percent for placebo).

Detrol LA is a once-daily medication with proven efficacy for 24 hours to help control the number and intensity of involuntary bladder muscle contractions that cause wetting accidents, and reduce the strong urinary urgency associated with overactive bladder.

Since its introduction in January 2001, Detrol LA has become the number one prescribed treatment for overactive bladder in the United States and has been prescribed to more than 7 million patients worldwide. Detrol LA is indicated for the treatment of overactive bladder with symptoms of urgency, urge incontinence, and frequency. An estimated 33 million people in the United States suffer from the symptoms of overactive bladder. Detrol LA is not indicated for stress or mixed incontinence.

Detrol LA is contraindicated in patients with urinary retention, gastric retention, or uncontrolled narrow-angle glaucoma and in patients who have demonstrated hypersensitivity to the drug or its ingredients.

Patients with the following conditions should be treated with caution: renal impairment, bladder outflow obstruction, gastrointestinal obstructive disorders, controlled narrow-angle glaucoma, and significantly reduced hepatic function.

Dry mouth was the most frequently reported adverse event (Detrol LA 23 percent vs. placebo 8 percent); others (more than or equal to 4 percent) included headache (Detrol LA 6 percent vs. placebo 4 percent), constipation (Detrol LA 6 percent vs. placebo 4 percent), and abdominal pain (Detrol LA 4 percent vs. placebo 2 percent).

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