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First North American experience of propiverine use in children with overactive bladder
Élisabeth Lapointe1, Narcisse Singbo1, Élizabeth Naud1
1Division of Urology, CHU de Québec - Université Laval Research Centre, Quebec, QC, Canada.
Insights
Propiverine is an effective and safe treatment for pediatric overactive bladder (OAB), showing significant improvements in bladder capacity and comparable tolerability to other OAB medications.
Area of Science:
- Pediatric Urology
- Pharmacology
- Clinical Trials
Background:
- Propiverine was approved in Canada in 2017 for overactive bladder (OAB) in adults and children.
- Limited data exists on its efficacy and tolerability in pediatric populations.
Purpose of the Study:
- To assess the efficacy and tolerability of propiverine for pediatric OAB.
- To compare propiverine with other medications used for OAB in historical cohorts.
Main Methods:
- Retrospective analysis of a prospectively maintained database of 58 pediatric patients treated with propiverine since 2017.
- Efficacy and tolerability assessed via voiding diaries, postvoid residuals, changes in incontinence/urgency episodes, and adverse events.
Main Results:
- Mean bladder capacity increased from 120 ml to 216 ml (% expected bladder capacity increased from 37% to 59%).
- Average increase in % expected bladder capacity was 0.5% per month (p<0.001).
- Propiverine demonstrated comparable efficacy and tolerability to other OAB treatments, with 7 patients discontinuing due to side effects.
Conclusions:
- Propiverine is an efficient and safe treatment option for pediatric overactive bladder.
- The study's limitations include its retrospective design and lack of a placebo group.
Introduction:
In 2017, propiverine was approved in Canada for overactive bladder (OAB) in adults and children. There is, however, scarce data on its efficacy and tolerability in the pediatric population. Our primary objective was to assess the efficacy and tolerability of propiverine as a treatment for pediatric OAB. Our secondary objective was to compare propiverine to molecules already investigated in historical cohorts.
Methods:
We conducted a retrospective analysis of a prospectively maintained database and reviewed 58 patients who received propiverine since 2017. Efficacy and tolerability were assessed through voiding diaries, postvoid residuals (PVR), changes in the number of incontinence and urgency episodes (grade 1 to 3), and on reported adverse events.
Results:
In total, 58 patients (37 boys) initiated treatment at a mean age of 9.5±3.2 years. Patients were on propiverine for an average of 15.9±12.4 months. Mean bladder capacity increased from 120 ml to 216 ml, and % expected bladder capacity (%EBC) increased from 37% to 59%. The average increased rate of %EBC was 0.5% per month (p<0.001). Of the 58 patients, eight stopped the medication completely without symptom recurrence, 21 were still on medication, and six were on dose-tapering. Due to side effects, seven interrupted their treatment. Compared to molecules used in our service, propiverine offered comparable efficacy and tolerability. Our study had limitations, including the absence of a placebo group and its retrospective design.
Conclusions:
Propiverine appears to be an efficient and safe option for treating OAB in children and is approved as such.
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