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Commentary RE: Tolterodine Once Daily: Superior Efficacy and Tolerability in the Treatment of the Overactive Bladder

  • Karl J. Kreder
    Correspondence
    Address correspondence to: Karl J. Kreder, M.D., M.B.A., Department of Urology, 200 Hawkins Drive, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242.
    Affiliations
    University of Iowa, Iowa, IA
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      Prior to 1990, treatment options for patients with overactive bladder were relatively limited. Oxybutynin and hyoscyamine were the primary pharmacologic agents used at the time. Both of these agents were developed primarily for gastrointestinal conditions and were used secondarily for the treatment of overactive bladder. Both were immediate-release formulations and required multiple dosages per day and had significant side effect profiles which often led to the discontinuation of therapy. If pharmacologic treatment failed, patients were left with few options except surgery, with augmentation cystoplasty being the most common procedure performed for treatment.
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      • Tolterodine once-daily: superior efficacy and tolerability in the treatment of the overactive bladder
        UrologyVol. 57Issue 3
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          Objectives. To evaluate the efficacy and tolerability of a new extended-release (ER), once-daily, capsule formulation of tolterodine, relative to placebo and the existing immediate-release (IR), twice-daily, tablet formulation, for treatment of the overactive bladder. Methods. This was a double-blind, multicenter, randomized, placebo-controlled trial. One thousand five hundred twenty-nine patients (81% women) with urinary frequency (eight or more micturitions every 24 hours) and urge incontinence (five or more episodes per week) were randomized to oral therapy with tolterodine ER 4 mg once daily (n = 507), tolterodine IR 2 mg twice daily (n = 514), or placebo (n = 508) for 12 weeks.
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