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Tolterodine Extended Release Improves Storage Symptoms in Men With Overactive Bladder on Alpha-Blocker Therapy: Presented at EAU

By Jill Stein

MILAN, Italy -- March 28, 2008 -- Men with overactive bladder (OAB) symptoms receiving alpha-blocker therapy for lower-urinary-tract symptoms (LUTS) appear to respond to therapy with tolterodine extended release (ER), researchers reported here at the 23rd Annual European Association of Urology (EAU) Congress.

Christopher Chapple, MD, Consultant Urologic Surgeon, Royal Hallamshire Hospital, Sheffield, United Kingdom, and colleagues elsewhere randomised 652 men aged 40 years or more to 12 weeks of treatment with tolterodine ER 4 mg/day plus an alpha blocker or to placebo plus an alpha blocker.

"Lower-urinary-tract symptoms in men are usually treated first with pharmacologic agents that target the prostate and/or bladder outlet, such as alpha blockers and 5 alpha reductase inhibitors," Dr. Chapple pointed out in a presentation on March 27. However, he added, "some men continue to experience OAB symptoms despite alpha-blocker therapy for LUTS."

Antimuscarinics such as tolterodine ER are the first-line pharmacological therapy for OAB, he said.

Several studies have suggested that men with LUTS and OAB symptoms may benefit from addition of tolterodine ER to their alpha-blocker therapy.

At baseline, eligible subjects had mean micturition frequency of at least 8 episodes per 24 hours and at least 1 urgency episode per 24 hours with or without urgency urinary incontinence.

Compared with placebo plus alpha-blocker therapy, tolterodine ER plus alpha-blocker treatment resulted in greater reductions from baseline in the number of micturitions (P = .0079), urgency episodes (P = .0010), and severe urgency episodes (P = .0495) per 24 hours, as well as in the frequency-urgency sum (P = .0065).

The tolterodine-ER-plus-alpha-blocker group also had greater improvement in the International Prostate Symptom Score storage domain score and in OAB-questionnaire Symptom Bother and Coping scare scores.

No clinically meaningful changes were observed in postvoid residual urine volume or maximum flow rate among men treated with combination therapy.

"The findings are consistent with prior studies that have shown increased efficacy of tolterodine ER plus alpha blockers for treating OAB symptoms in men with LUTS," Dr. Chapple said.


[Presentation title: Tolterodine Extended Release Improves Overactive Symptoms in Bladder Symptoms in Men Receiving Alpha-Blocker Therapy. Abstract 671]

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