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Solifenacin for overactive bladder: a systematic review and meta-analysis
Deyi Luo1, Liangren Liu, Ping Han
1Department of Urology, West China Hospital, Sichuan University, Guoxue Xiang #37, Chengdu, Sichuan 610041, People's Republic of China.
Abstract:
This study aims to evaluate the efficacy and safety of solifenacin for treating overactive bladder. Randomized controlled trials (RCTs) were identified and extracted from MEDLINE, Embase, and CENTRAL. The quality of the included RCTs was assessed using the Jadad score, and heterogeneity was analyzed using the chi-squared test. The data of the included RCTs were collected, extracted, and assessed by our protocol. A total of nine RCTs were identified from the search strategy. Compared with the placebo and tolterodine treatments, both short-term (mostly 12-week) trials indicated that solifenacin significantly reduced urgency episodes, micturitions, and incontinence episodes per 24 h. Compared with the solifenacin (5 mg) group, the solifenacin (10 mg) group was significantly better in terms of the number of micturitions per 24 h. With regard to adverse effects, the patients treated with solifenacin had significantly higher rates of constipation and blurred vision than patients treated with tolterodine. The solifenacin therapy was not inferior to tolterodine in terms of efficacy profiles and had a similar incidence of overall adverse events compared with tolterodine treatment. Solifenacin (5 mg) is thus a recommended dose because of its reported balance between efficacy and acceptable tolerability.
Insights
Solifenacin effectively treats overactive bladder symptoms like urgency and incontinence. The 5 mg dose is recommended for its balance of efficacy and tolerable side effects, such as constipation and blurred vision.
Area of Science:
- Pharmacology
- Urology
Background:
- Overactive bladder (OAB) is a common condition characterized by urinary urgency.
- Current treatments aim to improve quality of life by managing OAB symptoms.
Purpose of the Study:
- To evaluate the efficacy and safety of solifenacin for overactive bladder treatment.
- To compare solifenacin with placebo and tolterodine through a meta-analysis of randomized controlled trials (RCTs).
Main Methods:
- Systematic review and meta-analysis of nine RCTs.
- Data extracted and assessed using a predefined protocol.
- Study quality evaluated with the Jadad score; heterogeneity assessed using the chi-squared test.
Main Results:
- Solifenacin significantly reduced urgency, micturition, and incontinence episodes compared to placebo and tolterodine.
- Solifenacin 10 mg showed greater efficacy than 5 mg for reducing micturitions.
- Higher rates of constipation and blurred vision were observed with solifenacin versus tolterodine, though overall adverse event incidence was similar.
Conclusions:
- Solifenacin is an effective treatment for overactive bladder, comparable in efficacy to tolterodine.
- Solifenacin 5 mg offers a favorable balance of efficacy and tolerability.
- Adverse effects like constipation and blurred vision warrant consideration in clinical practice.
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