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Overactive bladder: improving the efficacy of anticholinergics by dose escalation
1Department of Urology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA. smacdiar@wfubmc.edu
Current Urology Reports
|November 19, 2003
Summary
New antimuscarinic medications improve overactive bladder (OAB) treatment, but higher doses may boost efficacy. Dose escalation, especially with extended-release oxybutynin, is explored to enhance continence for OAB patients.
Area of Science:
- Urology
- Pharmacology
Background:
- Overactive bladder (OAB) significantly impacts millions of lives.
- New antimuscarinic anticholinergic drugs offer improved OAB treatment with fewer side effects.
Purpose of the Study:
- To critically evaluate the benefits and drawbacks of anticholinergic dose escalation for OAB.
- To explore strategies for improving treatment efficacy in OAB patients.
Main Methods:
- Literature review of anticholinergic efficacy and dose escalation.
- Analysis of US Food and Drug Administration (FDA)-approved dosing for extended-release oxybutynin.
Main Results:
- Anticholinergics reduce urge incontinence episodes by 46-92%.
- Dose escalation can enhance anticholinergic efficacy, though not routinely practiced.
- Extended-release oxybutynin facilitates dose escalation and has FDA approval.
Conclusions:
- Dose escalation is a viable strategy to improve OAB treatment outcomes.
- Further investigation into routine dose escalation is warranted to optimize patient continence.