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Title: Tolterodine (Detrol LA) Decreases Urinary Urgency: Presented at ICS

"Tolterodine (Detrol LA) Decreases Urinary Urgency: Presented at ICS"

By Jill Stein PARIS, FRANCE -- August 26, 2004 -- Treatment with tolterodine tartrate extended-release capsules (Detrol LA) significantly increases the urgency-free interval in patients with overactive bladder, researchers report. Vik Khullar, MD, Senior Lecturer and Consultant Urogynaecologist, Department of Obstetrics and Gynecology, St. Mary's Hospital, London, United Kingdom, presented the findings here on August 26[^th at the Joint Meeting of the International Continence Society and the International UroGynecological Association.

Although urgency is the most bothersome symptom of overactive bladder, researchers have not been able to quantify symptom relief.

Dr. Khullar and co-workers randomised 597 patients to 12 weeks of treatment with tolterodine extended release 4 mg per day or placebo.

Subjects were 18 years of age or older and had overactive bladder symptoms for at least 6 months, including urinary urgency and urinary frequency (8 or more episodes over 24 hours), with or without incontinence. Patients had a mean age of 59 years, and nearly half of them reported having urgency symptoms for more than 5 years.

During the trial, patients maintained detailed charts recording the times of their voids, symptoms of urgency, and episodes of urge incontinence. For 7 days, patients were instructed to time the interval between the onset of urgency (primary end point) and the time that they voided (primary end point) using a stopwatch. Patients also completed the Patient Perception of Urgency Scale (PPUS).

The mean urgency-free interval was approximated by calculating the total time between any voids without urgency and the total time from onset of urgency to void, subtracted from the number of days data were collected.

By week 12, the urgency-free interval was significantly greater in the tolterodine extended release group than in the placebo group (31.4 minutes versus 19.7 minutes, P =.009). There also was a significantly larger decrease in the number of urgency episodes per day with tolterodine extended release (median change of 43%) compared with placebo (median change of 34%, P =.041).

The PPUS scores showed a greater improvement from baseline with tolterodine than with placebo (52% vs. 43%), but the between-group difference was not significant when adjusted as a co-primary end point (P =.025).

"The findings demonstrate that treatment with tolterodine extended release increases the urgency-free interval in patients with the bothersome symptom of overactive bladder," Dr. Khullar said. "The medication prolongs the filling phase, delays the sensation of urgency, and decreases urgency episodes, thereby improving quality of life."

Overactive bladder, defined as urinary urgency with or without incontinence, usually with frequency and nocturia, affects 17% of the U.S. population and 12% to 22% of Europeans 40 years of age or older.

The study was sponsored by Pfizer.

[Abstract title. "Tolterodine Increases The Urgency-Free Interval: A Sensory and Motor Effect?" Abstract 172]

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