Re: Influence of the Short-Term Intake of High Doses of Solifenacin and Trospium on Cognitive Function and Health-Related Quality of Life in Older Women with Urinary Incontinence
Abstract
available at http://www.ncbi.nlm.nih.gov/pubmed/29609422 Editorial Comment: Antimuscarinic agents have been among the mainstays of pharmacotherapy for treatment of overactive bladder. However, there has been concern about use of these medications in geriatric patients due to potential adverse events, including cognitive dysfunction. There has also been recent interest in using combination therapy to potentiate clinical improvement in lower urinary tract symptoms, particularly with agents that have different spectrums of action or muscarinic receptor selectivity. However, this approach also raises safety concerns. This study examined cognitive and health related quality of life outcomes using validated measures in a group of 312 older women (age 60 to 83 years) with overactive bladder randomized to 1 of 3 treatment groups. Group 1 took high doses of solifenacin and trospium, group 2 took lower daily doses of both agents and group 3 took placebos. All subjects had normal baseline cognitive function. At 8 weeks urinary tract symptoms and health related quality of life measures were all significantly improved compared to baseline in the active treatment groups but not in the placebo group. Some subjects randomized to placebo actually dropped out due to lack of clinical efficacy. The authors acknowledge a need to examine other factors in the future, including the role of postvoid residual volume and the potential use of drug dose de-escalation following initial improvement. Also,…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 1,523 participants or records.
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