Efficacy and safety of solifenacin for overactive bladder: An updated systematic review and meta-analysis

Area of Science:

• Urology
• Pharmacology
• Clinical Medicine

Background:

• Overactive bladder (OAB) is a chronic condition characterized by urinary urgency, with or without incontinence.
• Solifenacin, an antimuscarinic agent, is a key treatment for OAB due to its selective action on bladder receptors.
• While effective, understanding the safety and efficacy profile of solifenacin necessitates ongoing research and data synthesis.

Purpose of the Study:

• To systematically review and meta-analyze the efficacy and safety of solifenacin in managing overactive bladder (OAB).
• To provide an updated assessment of solifenacin's impact on key OAB symptoms and associated adverse events.

Main Methods:

• Adherence to PRISMA 2020 guidelines and PROSPERO registration (CRD42023445318).
• Comprehensive literature search across PubMed, ScienceDirect, and Scopus databases up to July 2023.
• Meta-analysis of data using Review Manager version 5.4.

Main Results:

• Solifenacin significantly reduced urgency episodes (MD = -1.09), incontinence episodes (MD = -0.56), micturition frequency (MD = -1.01), and nocturia episodes (MD = -0.13) compared to placebo.
• Patients on solifenacin showed a significant increase in 24-hour urine volume (MD = 26.88).
• A significantly higher incidence of adverse events (AEs) was observed in the solifenacin group (MD = 1.75) versus placebo.

Conclusions:

• Solifenacin demonstrates significant efficacy in improving core symptoms of overactive bladder, including urgency, incontinence, and frequency.
• The use of solifenacin is associated with a statistically significant increase in adverse events.
• Clinicians should carefully weigh the therapeutic benefits against the potential for adverse events when prescribing solifenacin for OAB management.