Abstract

Objectives. To prospectively examine the efficacy and safety of propiverine hydrochloride in patients with overactive bladder (OAB) symptoms who poorly responded to previous treatment with solifenacin, tolterodine or imidafenacin. Methods. Patients aged ≥20 with persisting OAB symptoms (≥6 in OAB symptom score (OABSS)) even after at least 4-week treatment using solifenacin, tolterodine or imidafenacin were enrolled. Propiverine 20 mg/day was administered for 12 weeks to 70 patients who desired the further improvement of OAB symptoms and 3 who had intolerable adverse events of previous drugs. The OABSS and postvoid residual urine volume (PVR) were determined before and at 4 and 12 weeks of treatment. Results. Of 73 patients enrolled (29 males and 44 females, median age 71 years), 52 completed the protocol treatment. The OABSS was significantly improved by propiverine treatment (9.0 at baseline, 6.2 at 4 weeks, 6.3 at 12 weeks (P < 0.001)). The scores of OAB symptoms (nighttime frequency, urgency and urge incontinence) except daytime frequency also improved significantly. No increase in PVR was observed. The most frequent adverse event was dry mouth (13.7%), followed by constipation (6.8%). Conclusions. Propiverine is useful to improve OAB for patients who poorly respond to solifenacin, tolterodine or imidafenacin.

Highlights

  • Overactive bladder (OAB), a syndrome that presents urinary urgency as an essential symptom [1], has a great impact on the quality of life (QOL) of the patient

  • A double-blind randomized control study demonstrated that propiverine was superior to oxybutynin hydrochloride in terms of the improvement of pollakisuria and urinary incontinence associated with neurogenic bladder and unstable bladder [5]

  • We examined the clinical efficacy and safety of propiverine for patients with OAB symptoms who poorly responded to previous treatment with solifenacin, tolterodine, or imidafenacin

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Summary

Introduction

Overactive bladder (OAB), a syndrome that presents urinary urgency as an essential symptom [1], has a great impact on the quality of life (QOL) of the patient. The study showed that 11.2% and 53.0% of subjects with OAB reported “an impact” and “a slight impact” on their QOL by OAB symptoms, respectively, through the impairment of mental health, vitality, physical activity, domestic work, and business work. Drugs with anticholinergic activity are the first-line drugs to treat OAB symptoms [3]. Propiverine hydrochloride is an agent with calcium antagonistic activity in addition to anticholinergic activity [4]. A double-blind randomized control study demonstrated that propiverine was superior to oxybutynin hydrochloride in terms of the improvement of pollakisuria and urinary incontinence associated with neurogenic bladder and unstable bladder [5]. Since its launch in 1993, propiverine hydrochloride has been widely used

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