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Efficacy and Safety of Combination Pharmacotherapy for Patients with Overactive Bladder: A Rapid Evidence Assessment. Eur Urol 2019; 76:767-779. [DOI: 10.1016/j.eururo.2019.07.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 07/05/2019] [Indexed: 02/02/2023]
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Kosilov K, Kuzina I, Kuznetsov V, Kosilova E. Influence of current state of executive function and working memory on adherence to antimuscarinic therapy in older women with OAB. Eur J Obstet Gynecol Reprod Biol X 2019; 4:100086. [PMID: 31517309 PMCID: PMC6728740 DOI: 10.1016/j.eurox.2019.100086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 07/19/2019] [Accepted: 07/20/2019] [Indexed: 11/03/2022] Open
Abstract
Aim Background Methods Results Conclusion
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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. Int Neurourol J 2018; 22:41-50. [PMID: 29609422 PMCID: PMC5885132 DOI: 10.5213/inj.1834996.498] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 01/27/2018] [Indexed: 11/29/2022] Open
Abstract
Purpose The aim of this study was to investigate the safety and the effects of elevated doses of solifenacin and trospium on cognitive function and health-related quality of life (HRQoL) in elderly women receiving treatment for urinary incontinence. Methods The study included 312 women aged 60–83 years (mean age, 69.4 years). All participants had scored at least 24 points on the Mini-Mental State Examination (MMSE) scale, and all of them had been diagnosed with urge urinary incontinence (UUI) or mixed urinary incontinence (MUI). The women were randomly assigned to 3 groups: group A, individuals who were simultaneously administered solifenacin at a high dosage of 20 mg per day and trospium at a high dosage of 60 mg per day; group B, persons taking solifenacin and trospium at the usual dosage of 10 and 30 mg per day, respectively; and group C, persons who received a placebo. Participants’ cognitive status was assessed by the MMSE, Controlled Oral Word Association Test, Wechsler Adult Intelligence Scale-Revised, Wechsler Memory Scale III, Colour Trails Test, and California Verbal Learning Test scales. The HRQoL assessment was performed using the Medical Outcomes Study 36-Item Health Survey. Results The cognitive function parameters did not differ at the start and end of the study across the groups (P>0.05). Additionally, the cognitive function parameters did not differ significantly within each group between the start and end of the study (P>0.05). The values of most HRQoL parameters regarding the functional state of the lower urinary tract (LUT) after the termination of treatment significantly improved in groups A and B (P<0.05). A significant correlation between cognitive status and HRQoL or LUT parameters was absent (r<0.3), while the correlations between HRQoL and LUT parameters were r=0.31–0.83, P<0.05. Conclusions The use of elevated doses of solifenacin and trospium did not increase the risk of cognitive impairment in women with UUI and MUI. The combination of solifenacin and trospium at a double dosage may be recommended to elderly women with treatment-resistant symptoms of UUI and MUI. However, the safety of combining antimuscarinic drugs in women with an increased volume of residual urine requires further study.
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Kosilov K, Loparev S, Kuzina I, Shakirova O, Zhuravskaya N, Lobodenko A. Self-assessment of treatment compliance with antimuscarinic drugs and lower urinary tract condition among women with urinary incontinence. Int Urogynecol J 2017; 28:1663-1669. [PMID: 28429053 DOI: 10.1007/s00192-017-3333-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 03/29/2017] [Indexed: 11/26/2022]
Abstract
AIM Our aim was to determine the efficiency of the Medication Compliance Self-Report Inventory (MASRI) in self-reporting antimuscarinic drug treatment compliance among women with urinary incontinence (UI). MATERIALS AND METHODS The study assessed 347 women aged 18-65 (averaging 49.7) years with more than one urinary incontinence (UI) episode per day. Treatment compliance was tested at the beginning and at weeks 4, 8, and 12 using the MASRI, the Brief Medication Questionnaire (BMQ), and visual pill counts. The MASRI's constructive, concurrent, and discriminate validity was studied in comparison with an external standard that uses the chi-square and Spearman coefficient. Receiver operating characteristic (ROC) analysis was performed to identify optimum MASRI cutoffs that would predict noncompliance. Furthermore, the functional condition of the lower urinary tract was tested using voiding diaries, uroflowmetry, and cystometry. RESULT The correlation between the percentage of noncompliant women according to the MASRI, and individuals with a belief barrier with respect to the BMQ screen was r = 0.81 (p ≤0.05), r = 0.84 (p ≤0.05), and r = 0.79 (p ≤0.05). The correlation between the percentage of noncompliant women according to the MASRI and of women who missed >20% of their doses according to the Regimen Screen of the BMQ was r = 0.79, p ≤0.05, r = 0.82, p ≤0.01, r = 0.77, and p ≤0.05 at the control points. Finally, the percentage of noncompliant patients who self-reported correctly according to the MASRI data compared with the BMQ was 95.6%, 95.7%, and 96.6% at the control points. CONCLUSION The MASRI entails acceptable validity for accurately predicting treatment compliance with antimuscarinic drugs among women who have had UI for >3 months.
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Affiliation(s)
- Kirill Kosilov
- Department of Social and Psychologikal Science, Far Eastern Federal University, Ayax, 10, F733, Vladivostok, Primorsky Region, Russian Federation.
| | - Sergey Loparev
- Department of Urology, City Polyclinic № 3, Lugivaya 50, Vladivostok, Russian Federation
| | - Irina Kuzina
- Department of Social and Psychologikal Science, Far Eastern Federal University, Ayax, 10, F733, Vladivostok, Primorsky Region, Russian Federation
| | - Olga Shakirova
- Department of Theory and Methods of Adaptive Physical Education, Far Eastern Federal University, Ayax, 10, S1, Vladivostok, Russian Federation
| | - Natalya Zhuravskaya
- Department of Theory and Methods of Adaptive Physical Education, Far Eastern Federal University, Ayax, 10, S1, Vladivostok, Russian Federation
| | - Alexandra Lobodenko
- Department of Social and Psychologikal Science, Far Eastern Federal University, Ayax, 10, F733, Vladivostok, Primorsky Region, Russian Federation
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Hsiao SM, Lin HH, Kuo HC. Treatment Outcome of Overactive Bladder Patients Receiving Antimuscarinic Therapy for More than One Year. Low Urin Tract Symptoms 2016; 10:21-26. [PMID: 27515567 DOI: 10.1111/luts.12136] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 03/01/2016] [Accepted: 03/22/2016] [Indexed: 01/23/2023]
Abstract
OBJECTIVES Details on the therapeutic effects of long-term antimuscarinic therapy have not been reported. Thus, the aim of this study is to evaluate the detailed long-term therapeutic effect of antimuscarinic therapy. METHODS All consecutive patients who visited the urologic outpatient clinics of a medical center for treatment of overactive bladder syndrome and received antimuscarinic therapy of 12 months or more were retrospectively reviewed. All medical records, including the Overactive Bladder Symptom score (OABSS), the modified Indevus Urgency Severity Scale and the International Prostate Symptoms score (IPSS) questionnaires, and uroflowmetry parameters were reviewed at each visit. RESULTS A total of 140 patients had received 12 months or more of antimuscarinic therapy. Sustained therapeutic effects were observed by persistent decreases of IPSS-storage score, IPSS-total score and OABSS score. Moreover, the maximum flow rate did not change over time. A temporary increase in postvoid residual volume and decrease in voiding efficiency were found, but these parameters improved over long-term visits. Side-effects were observed in 81 patients (57.9%) and included dry mouth (n = 58, 41.4%), constipation (n = 48, 34.3%) and blurred vision (n = 4, 2.9%); all side-effects were tolerable. Patients aged 75 years or more (n = 94) had a higher comorbidity rate (n = 46, 48.9%) before treatment but generally exhibited similar therapeutic effects as overall patients; elderly patients could also tolerate side-effects. CONCLUSION Sustained therapeutic effects were observed in patients who received 12 months or more of antimuscarinic therapy, even in elderly patients. In addition, side-effects in patients receiving long-term therapy were also common but tolerable.
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Affiliation(s)
- Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, Taiwan
| | - Ho-Hsiung Lin
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| | - Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
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Chen JL, Chen SF, Jiang YH, Kuo HC. Practical points in the medical treatment of overactive bladder and nocturia in the elderly. Tzu Chi Med J 2016; 28:1-5. [PMID: 28757708 PMCID: PMC5509172 DOI: 10.1016/j.tcmj.2015.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 12/08/2015] [Accepted: 12/10/2015] [Indexed: 11/26/2022] Open
Abstract
The prevalence of overactive bladder (OAB) increases with age. Degeneration of the central nervous system in the elderly has been proposed as one of the pathogenic factors of OAB. Antimuscarinic therapy is effective in the treatment of OAB; however, intolerable systemic adverse events and cognitive dysfunction during treatment with nonselective antimuscarinic agents is of growing concern in elderly patients. The newly developed beta-3 adrenoceptor agonist mirabegron does not adversely affect flow rate and detrusor pressure, and its therapeutic efficacy and tolerability are similar in patients aged > 65 years and > 75 years, suggesting it might be the therapeutic choice in older patients with OAB. Nocturia can cause sleep deprivation at night and increase daytime sleepiness and loss of energy in the elderly. Desmopressin add-on therapy is effective in improving nocturia and storage symptoms. However, elderly patients with a baseline serum sodium level below the normal range are at high risk of developing significant hyponatremia.
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Affiliation(s)
- Jing-Liang Chen
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
| | - Sheng-Fu Chen
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
| | - Yuan-Hong Jiang
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
| | - Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
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Kosilov KV, Loparev SA, Ivanovskaya MA, Kosilova LV. The efficacy of different doses of solifenacin in elderly patients after treating a urinary tract infection. Arab J Urol 2015; 13:203-8. [PMID: 26413348 PMCID: PMC4563008 DOI: 10.1016/j.aju.2015.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 06/29/2015] [Accepted: 07/02/2015] [Indexed: 11/05/2022] Open
Abstract
Objective To determine the efficacy and safety of solifenacin for correcting the residual symptoms of an overactive bladder (OAB) in patients who were treated for a urinary tract infection (UTI). Patients and methods Using random sampling, 524 patients aged >60 years were selected (347 women, 66.2%, and 177 men, 33.8%). They denied the presence of any symptoms of detrusor overactivity in their medical history, but had a diagnosis of a UTI. At least 1 month after the end of treatment and a laboratory confirmation of the absence of infection, each patient completed an OAB-Awareness Tool questionnaire (OAB signs, total score 8 points), and a noninvasive examination of urinary function (uroflowmetry). Each day patients in group A took solifenacin 10 mg and those in group B took 5 mg, with patients in group C being given a placebo. Results During the study 58.8% of patients had symptoms of an OAB at 1 month after the end of the treatment for a UTI, and normal laboratory markers. During treatment with the standard and higher dose of solifenacin, within 8 weeks most variables of the condition of the lower urinary tract reached a normal state or improved. Conclusion Patients aged >60 years who had been treated for a UTI have a high risk of developing symptoms of an OAB. Solifenacin in standard doses is an efficient and safe means of managing overactive detrusor symptoms after a UTI.
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Affiliation(s)
- Kirill V Kosilov
- School of Humanities, Far Eastern Federal University, Russian Federation
| | - Sergay A Loparev
- Department of Urology, City Polyclinic No. 3, Russian Federation
| | | | - Liliya V Kosilova
- Department of the Functional Methods of Examination, Medical Association No. 2 of Vladivostok City, Vladivostok, Primorsky Region, Russian Federation
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Kosilov KV, Loparev SA, Ivanovskaya MA, Kosilova LV. Influence of different doses of trospium and solifenacin on manageability of OAB symptoms with different severity in elderly men and women. JOURNAL OF CLINICAL UROLOGY 2015. [DOI: 10.1177/2051415815600970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objective: We studied the rationale for using standard and increased dosages of solifenacin and trospium against overactive bladder (OAB) symptoms of different severity among elderly patients. Methods: A total of 327 patients took part in the study: 199 women and 128 men older than 65 years (median age 69.1). The state of the lower urinary tracts was estimated by cystometry, ICIQ-SF and bladder diaries. Frequency of urgency urinary incontinence (UUI) was taken as a criterion of OAB symptom severity. Result: Administration of double-dosed trospium and solifenacin leads to decrease of frequency of UUI both in the group with severe symptoms (B1: 6.1 (0.5) →2.4 (0.9), p ⩽ 0.05), and in the group with moderate symptoms of OAB (A1: 2.8 (0.8) →0.5 (0.4), p ⩽ 0.001). Under a combination of trospium and solifenacin in doses recommended by manufacturers, UUI decreased authentically in the group with moderate symptoms (A2: 2.9 (0.5) →0.9 (0.5), p ⩽ 0.05) and unauthentically in the group with severe symptoms of detrusor dysfunction (B2: 7.0 (1.2) → 4.3 (1.5), p ⩾ 0.05). During the experiment six patients (1.8%) elected not to participate because of intolerable adverse events. Forty-seven more individuals (14.4%) felt adverse effects, among which the most frequent were: xerostomia (15 patients or 4.6%), faintness (nine patients or 3.8%), dryness of integuments (six patients or 1.8%). Conclusion: A standard-dose combination of solifenacin and trospium in older patients with moderate symptoms of OAB enables a good therapeutic effect in a short time without increasing risk of side effects. High therapeutic doses of antimuscarinic drugs are reasonable for older men and women with severe symptoms of OAB. Increasing the dose of simultaneous use of solifenacin and trospium yields a good therapeutic effect to correct UUI; however, it raises the hazard of appearance of adverse effects. The number of side effects in the group of elderly individuals who were taking the combination of increased and standard dosages of solifenacin and trospium does not significantly differ.
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Affiliation(s)
- Kirill V Kosilov
- Far Eastern Federal University, Department of Social Sciences, Russian Federation
| | - Sergey A Loparev
- Department of Urology, City Polyclinic no. 3, Russian Federation
| | | | - Liliya V Kosilova
- Department of the Functional Methods of Examination, Med. Association no. 2 of Vladivostok-City, Russian Federation
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Kosilov KV, Loparev SA, Ivanovskaya MA, Kosilova LV. Effectiveness of Solifenacin and Trospium for Managing of Severe Symptoms of Overactive Bladder in Patients With Benign Prostatic Hyperplasia. Am J Mens Health 2015; 10:157-63. [DOI: 10.1177/1557988315595692] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This research is aimed to study the possibility of management of severe symptoms of overactive bladder (OAB) with solifenacin and trospium in patients who receive treatment with tamsulosin due to benign prostatic hyperplasia (BPH). The 338 men more than 50 years old (average age 58.4 years) diagnosed with BPH and severe symptoms of OAB were enrolled in the study. Over three episodes of urinary incontinence per day (registration according to bladder diaries), International Prostate Symptom Score over 19, OAB-V8 questionnaire score over 32, and urodynamic disorders diagnosed using cystometry and uroflowmetry were taken as a criterion of severe symptoms of OAB. Patients of the main group during 2 months received treatment with daily combination of solifenacin 5 mg and trospium 5 mg simultaneously with tamsulosin 0.4 mg. Patients of the control group were treated only with tamsulosin. First endpoint is a quantitative assessment of patients with BPH having severe symptoms of OAB. Second endpoint is a state of the patients’ lower urinary tract after the treatment. In the main group, most of urodynamic indices normalized significantly. Number of episodes of incontinence reduced from middle level 3.4 (0.8) per day to 0.9 (0.7) per day. In the control group changes of urodynamic indices were not significant. Quantity of side effects did not exceed the level which is common for antimuscarinic monotherapy. Therefore, percentage of patients with severe symptoms of OAB is not less than 44% of all cases of prostatic hyperplasia accompanied by OAB symptoms. Combination of trospium and solifenacin in standard doses is an efficient and safe method of management of severe symptoms of OAB in the course of the treatment of with tamsulosin in patients more than 50 years of age.
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Kosilov K, Loparev S, Ivanovskaya M, Kosilova L. Additional correction of OAB symptoms by two anti-muscarinics for men over 50 years old with residual symptoms of moderate prostatic obstruction after treatment with Tamsulosin. Aging Male 2015; 18:44-8. [PMID: 25136746 DOI: 10.3109/13685538.2014.951922] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To study the effectiveness and safety of combined standard-dosed Solifenacin and Trospium for management of symptoms of overactive bladder (OAB) in elderly patients after the treatment with Tamsulosin. PATIENTS AND METHODS A total of 417 men over 50 years of age (average age 57.9 (8.3)) with diagnosed prostatic obstruction (score 8-19 according to I-PSS), who had not taken Tamsulosin before, were enrolled in the study. I-PSS questionnaire (from 8 to 19 - moderate) and Awareness Tool questionnaire for evaluating OAB symptoms (total score for OAB symptoms over 8) were used at the beginning and at the end of the observation. Also, urodynamic parameters were examined. RESULT Percentage of patients with prevalent symptoms of obstruction of urethra decreases after the treatment with Tamsulosin and then rises again (36.2%), but absolute number of patients remains smaller than initial data. Percentage of patients with relative prevalence of symptoms of overactive bladder slightly increases against administration of Tamsulosin and reaches initial values at the time of administration of anti-muscarinic drugs with absolute decrease in number of such patients. CONCLUSION Combination of Trospium and Solifenacin is an effective way to manage residual symptoms of hyperactive bladder during treatment of early obstruction of urinary bladder.
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Affiliation(s)
- Kirill Kosilov
- Department of Social Sciences, Far Eastern Federal University , Vladivostok , RUVVO Russian Federation
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Kosilov KV, Loparev SA, Ivanovskaya MA, Kosilova LV. Comparative Effectiveness of Combined Low- and Standard-Dose Trospium and Solifenacin for Moderate Overactive Bladder Symptoms in Elderly Men and Women. Urol Int 2014; 93:470-3. [DOI: 10.1159/000363658] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 05/15/2014] [Indexed: 11/19/2022]
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