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Antimuscarinics for the treatment of overactive bladder: current options and emerging therapies

Sharath S Hegde1, Mathai Mammen, Jeffrey R Jasper

  • 1Theravance Inc., 901 Gateway Blvd, South San Francisco, CA 94087, USA. shegde@theravance.com

Current Opinion in Investigational Drugs (London, England : 2000)
|February 27, 2004
PubMed

Insights

Antimuscarinic drugs are common overactive bladder (OAB) treatments, but current options have tolerability and efficacy limits. New selective muscarinic receptor drugs are in development to improve OAB therapy.

Area of Science:

  • Pharmacology
  • Urology

Background:

  • Antimuscarinic drugs have been primary overactive bladder (OAB) treatments for over 20 years.
  • Current extended-release formulations of tolterodine and oxybutynin, while improved, have tolerability and efficacy limitations.
  • Ideal antimuscarinic medications should normalize bladder function without affecting other organ systems.

Purpose of the Study:

  • To review the current state of antimuscarinic drug therapy for overactive bladder (OAB).
  • To discuss the potential of novel, selective muscarinic receptor antagonists in improving OAB treatment.
  • To highlight the need for further clinical trials to evaluate new drug candidates.

Main Methods:

  • Review of current literature on antimuscarinic drugs for OAB.
  • Discussion of muscarinic receptor subtypes and their role in bladder function.
  • Analysis of emerging drug candidates with selective receptor-binding profiles.

Main Results:

  • Extended-release tolterodine and oxybutynin are current standards of care but are not ideal.
  • Advances in understanding muscarinic receptor pharmacology offer potential for improved therapies.
  • Several structurally diverse molecules targeting specific muscarinic subtypes are under development.

Conclusions:

  • Current antimuscarinic therapies for OAB have limitations in tolerability and efficacy.
  • Selective targeting of muscarinic receptor subtypes holds promise for developing more effective and safer OAB treatments.
  • Further clinical evaluation is necessary to determine the therapeutic value of novel antimuscarinic agents.

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