Tolterodine Aids Quality of Life in Older Women


WASHINGTON — Extended-release tolterodine improved overactive bladder problems and quality of life in sexually active postmenopausal women, according to a review of patient-reported outcomes presented in a poster at the annual meeting of the American Society for Reproductive Medicine.

“Physicians should consider the potential impact of [overactive bladder] symptoms and their treatment on postmenopausal patients' sexual function and quality of life,” wrote Dr. Gloria Bachmann of the University of Medicine and Dentistry of New Jersey, New Brunswick, and her colleagues.

The study was sponsored by Pfizer Inc., the manufacturer of Detrol LA extended-release tolterodine tartrate capsules.

Data from previous studies have shown that the prevalence of overactive bladder (OAB) in women increases with age and that the urinary symptoms that are associated with the condition are also associated with reduced sexual activity and quality of life.

To determine the effectiveness of the antimuscarinic agent tolterodine for relieving urinary incontinence and OAB, the investigators reviewed data from 211 postmenopausal women with OAB whose mean age was 56 years.

Of those, 112 women received 4 mg of extended-release tolterodine to be taken within 4 hours of bedtime each day for 12 weeks, and 99 women received a placebo for the same period.

The women completed several validated instruments at baseline and again at 12 weeks.

Overall, those in the tolterodine group reported significantly less use of absorbent pads and lower urination frequency, compared with those in the placebo group. The tolterodine group also reported fewer episodes of urgent urinary incontinence, but the difference was not statistically significant from the placebo group.

In addition, results from the Patient Perception of Bladder Condition showed that more of the tolterodine patients reported improvement in their symptoms than did placebo patients (74% vs. 62%, respectively). And the number of women in the tolterodine group who reported severe OAB problems dropped from 12% at baseline to 1% after 12 weeks, compared with a drop from 12% to 3% in the placebo group.

The treatment group also reported improvements in sexual function and quality of life from baseline to 12 weeks, based on the Physical, Behavioral/Emotive, Partner-Related, and total sections of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ). By contrast, the placebo patients reported significant improvements from baseline to 12 weeks only for the Physical section of the PISQ.

The total improvement in the PISQ scores for the treatment and placebo groups were 4.5% and 1.6%, respectively.

In addition, in the tolterodine group, overall quality-of-life scores were significantly higher after 12 weeks, compared with baseline, whereas quality-of-life scores were not significantly different in the placebo group after 12 weeks, compared with baseline.

No significant adverse events were reported in either of the groups during the study period, but the results were limited by the lack of long-term follow-up data beyond 12 weeks.

Dr. Bachmann has served as a consultant to Pfizer, and her three coinvestigators are currently employed by the company.

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