Comparisons of therapeutic efficacy and safety of solifenacin versus tolterodine in patients with overactive bladder: a meta-analysis of outcomes

Abstract

To compare the clinical efficacy and safety of solifenacin versus tolterodine in patients with overactive bladder (OAB). Literature searches were performed with PubMed, EMBASE, Ovid and Google Scholar databases, Wanfang and CNKI from inception to October 2013 for comparative studies assessing solifenacin and tolterodine for OAB. The data were extracted and evaluated by two reviewers independently according to the Cochrane Handbook for Systematic Reviews. Meta-analyses were conducted with RevMan 5.2. A total of 7 studies involving 1 805 patients were retrieved. Compared with tolterodine immediate release (IR), the number of urgency episodes and urge incontinence episodes in 24 h and the rate of dry mouth were significantly lower in patients on solifenacin (RR = -0.34, 95% CI: -0.50--0.18, P = 0.00; RR = -0.29, 95% CI:-0.55--0.04, P = 0.03; RR = 0.58, 95% CI: 0.41-0.83, P = 0.00) and the rate of constipation was higher in those on solifenacin (RR = 2.72, 95% CI: 1.38-5.39, P = 0.00). No significant differences existed between tolterodine IR and solifenacin in mean micturition volume per voiding and micturitions episodes in 24 h (P = 0.05,0.08). Between solifenacin and tolterodine extended release (ER), the number of urgency episodes, micturition and urge incontinence episodes in 24 h and mean micturition volume per voiding were not statistically different (all P > 0.05). The incidence of major adverse events, such as dry mouth, constipation and blurred vision, was not significantly different (all P > 0.05). And most adverse events were mild. Solifenacin is superior to tolterodine IR in treating OAB symptoms. However the rate of constipation is higher for solifenacin. Both solifenacin and tolterodine ER have similar therapeutic efficacies and adverse events.