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Propiverine Offers Benefits Over Oxybutynin for Pediatric Idiopathic Detrusor Overactivity: Presented at ICS

By Alison Palkhivala

MONTREAL, CANADA -- September 6, 2005 -- The antimuscarinic and calcium channel modulating agent propiverine may offer efficacy benefits over the antimuscarinic drug oxybutynin for the treatment of idiopathic detrusor overactivity in children, at least at higher doses. Propiverine also appears to be the better tolerated agent.

Investigators, led by Schahnaz Alloussi, MD, departments of urology and paediatric urology, Neunkirchen Hospital, Neunkirchen, Germany, explored the outcomes in children with urinary incontinence caused by idiopathic detrusor overactivity treated at one if 16 study centers with either propiverine (n = 437) or oxybutynin (n = 184). The primary endpoint of the study was achievement of continence. Their findings were presented in a poster here August 31^st at the 35^th annual meeting of the International Continence Society (ICS).

Both drugs were equally effective in terms of restoring continence. Overall, 61.6% of patients taking propiverine and 58.7% taking oxybutynin became continent with therapy. Multivariate analysis, however, revealed a trend toward superior efficacy with propiverine at higher doses. In addition, increasing doses of propiverine were associated with improved efficacy, while higher doses of oxybutynin did not result in such improvement. In fact, higher rates of incontinence were observed at the highest oxybutynin doses.

"Propiverine dosages (0.54 mg/kg body weight/day on average) could possibly be increased, thus further improving continence rates, whereas the administered oxybutynin dosages (0.31 mg/kg body weight/day on average) documented … declining continence rates [with higher doses]," wrote the authors.

Propiverine also worked faster than oxybutynin. Continence was documented after 186 days, on average, with propiverine, compared with an average of 259 days with oxybutynin. The average treatment period for patients taking propiverine was 208 days, compared with 303 days for those taking oxybutynin.

Only 3.9% of patients taking propiverine experienced side effects, compared with 16.3% of those taking oxybutynin. No serious adverse events occurred in either group. Adverse events occurred earlier in the propiverine group, and 1.6% of patients receiving this medication discontinued it prematurely due to adverse events, compared with 4.4% of those taking oxybutynin.

"Propiverine should be preferred to oxybutynin in the paediatric population," concluded the authors, "especially in cases requiring acceptable tolerability and safety."


[Presentation title: Efficacy, Tolerability and Safety of Propiverine Hydrochloride in Comparison to Oxybutynin in Children With Idiopathic Detrusor Overactivity -- A Multicenter Observational Cohort Study. Abstract 269.]

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