SEGURIDAD, TOLERANCIA Y EFICACIA A LARGO PLAZO DE TOLTERODINA DE LIBERACION SOSTENIDA EN EL TRATAMIENTO DE LA VEJIGA HIPERACTIVA: REVISION Y PUESTA AL DIA

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La tolterodina de liberación prolongada resultó eficaz, segura y bien tolerada en enfermos con vejiga hiperactiva tratados durante 12 meses.
kreder9.jpg Autor:
Karl Kreder,
Columnista Experto de SIIC

Institución:
Department of Urology University of Iowa Hospitals and Clinics Iowa, USA


Artículos publicados por Karl Kreder,
Recepción del artículo
22 de Marzo, 2004
Aprobación
21 de Abril, 2004
Primera edición
19 de Noviembre, 2004
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
Existen pocos estudios clínicos acerca de la eficacia, tolerancia y seguridad a largo plazo de los antimuscarínicos de liberación sostenida (LS) en el tratamiento de los síntomas de la vejiga hiperactiva (VH). En este trabajo se resumen los resultados de un estudio complementario a largo plazo (12 meses) en 1 077 enfermos con VH que recibieron cápsulas de tartrato de tolterodina LS (Detrol® LA; 4 mg, una vez al día). En el estudio abierto se demostró que la tolterodina LS es segura y se tolera bien. Además, la eficacia de la droga se mantuvo durante el período de tratamiento. La reducción en el número de episodios semanales de incontinencia y de micciones en 24 horas así como el aumento del volumen evacuado luego de 12 meses de terapia fueron comparables a los que se observaron luego de 12 semanas de tratamiento a doble ciego. La mejoría del paciente en la percepción de la patología vesical y en la urgencia miccional a los 12 meses fue semejante a la que se detectó con la terapia de 12 semanas. Los resultados se discuten en relación con los estudios a corto plazo con tolterodina LS y con otro agente antimuscarínico muy usado, oxibutinina (Ditropan®).

Palabras clave
Tolterodina LS, vejiga hiperactiva, tratamiento a largo plazao, seguridad, tolerabilidad, eficacia


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Abstract
There are few clinical studies about the long-term efficacy, tolerability, and safety of extended-release (ER) antimuscarinics for the treatment of overactive bladder (OAB) symptoms. In this paper, a long-term (12-month) extension study of 1 077 patients with OAB who were given tolterodine tartrate extended-release (ER) capsules (Detrol® LA; 4 mg once daily) is summarized. Tolterodine ER was demonstrated to be safe and well tolerated in this open-label study. In addition, the efficacy of tolterodine ER was maintained during the treatment period. That is, the reductions in the number of incontinence episodes per week and micturitions per 24 hours, and the increase in volume voided after 12 months of treatment were comparable to those observed after 12 weeks of double-blind treatment. Improvements in patient perception of bladder condition and urgency at 12 months compared with 12 weeks were also noted. These results are discussed in relation to short-term studies of tolterodine ER and another commonly used antimuscarinic agent, oxybutynin (Ditropan®).

Key words
Tolterodine ER, overactive bladder, long-term treatment, safety, tolerability, efficacy


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Clasificación en siicsalud
Artículos originales > Expertos del Mundo >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Farmacología, Urología
Relacionadas: Medicina Interna, Obstetricia y Ginecología



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Bibliografía del artículo
  1. Kreder K, Mayne C, Jonas U. Long-term safety, tolerability and efficacy of extended-release tolterodine in the treatment of overactive bladder. Eur Urol 2002;41:588-95.
  2. Herbison P, Hay-Smith J, Ellis G, et al. Effectiveness of anticholinergic drugs compared with placebo in the treatment of overactive bladder: systematic review. BMJ 2003;326:841-4.
  3. Stewart WF, Van Rooyen JB, Cundiff GW, et al. Prevalence and burden of overactive bladder in the United States. World J Urol 2003;20:327-36.
  4. Milsom I, Abrams P, Cardozo L, et al. How widespread are the symptoms of an overactive bladder and how are they managed A population-based prevalence study. BJU Int 2001;87:760-6.
  5. Andersson KE, Hedlund P. Pharmacologic perspective on the physiology of the lower urinary tract. Urology 2002;60:13-20.
  6. Abrams P, Freeman R, Anderstrom C, et al. Tolterodine, a new antimuscarinic agent: as effective but better tolerated than oxybutynin in patients with an overactive bladder. Br J Urol 1998;81:801-10.
  7. Drutz HP, Appell RA, Gleason D, et al. Clinical efficacy and safety of tolterodine compared to oxybutynin and placebo in patients with overactive bladder. Int Urogynecol J Pelvic Floor Dysfunct 1999;10:283-9.
  8. Todorova A, Vonderheid-Guth B, Dimpfel W. Effects of tolterodine, trospium chloride, and oxybutynin on the central nervous system. J Clin Pharmacol 2001;41:636-44.
  9. Chancellor MB. Tolterodine: selectivity for the bladder over effects of visual accommodation. J Urol 2000;163:229.
  10. Abrams P, Malone-Lee J, Jacquetin B, et al. Twelve-month treatment of overactive bladder: efficacy and tolerability of tolterodine. Drugs Aging 2001;18:551-60.
  11. Appell RA, Abrams P, Drutz HP, et al. Treatment of overactive bladder: long-term tolerability and efficacy of tolterodine. World J Urol 2001;19:141-7.
  12. Yarker YE, Goa KL, Fitton A. Oxybutynin. A review of its pharmacodynamic and pharmacokinetic properties, and its therapeutic use in detrusor instability. Drugs Aging 1995;6:243-62.
  13. Kelleher CJ, Cardozo LD, Khullar V, et al. A medium-term analysis of the subjective efficacy of treatment for women with detrusor instability and low bladder compliance. Br J Obstet Gynaecol 1997;104:988-93.
  14. Echols K, Verma U, Policaro F, et al. Idiopathic bladder hyperactivity and Ditropan: An efficacy and compliance issue. Obstet Gynecol 2000;95 (4 Suppl 1):S24.
  15. Eisen SA, Miller DK, Woodward RS, et al. The effect of prescribed daily dose frequency on patient medication compliance. Arch Intern Med 1990;150:1881-4.
  16. Van Kerrebroeck P, Kreder K, Jonas U, et al. Tolterodine once-daily: superior efficacy and tolerability in the treatment of the overactive bladder. Urology 2001;57:414-21.
  17. Olsson B, Szamosi J. Multiple dose pharmacokinetics of a new once daily extended release tolterodine formulation versus immediate release tolterodine. Clin Pharmacokinet 2001;40:227-35.
  18. Jonas U, Hofner K, Madersbacher H, et al. Efficacy and safety of two doses of tolterodine versus placebo in patients with detrusor overactivity and symptoms of frequency, urge incontinence, and urgency: urodynamic evaluation. The International Study Group. World J Urol 1997;15:144-51.
  19. Larsson G, Hallen B, Nilvebrant L. Tolterodine in the treatment of overactive bladder: analysis of the pooled phase II efficacy and safety data. Urology 1999;53:990-8.
  20. Siami P, Seidman LS, Lama D. A multicenter, prospective, open-label study of tolterodine extended-release 4 mg for overactive bladder: the speed of onset of therapeutic assessment trial (STAT). Clin Ther 2002;24:616-28.
  21. Rovner ES, Wein AJ. Once-daily, extended-release formulations of antimuscarinic agents in the treatment of overactive bladder: a review. Eur Urol 2002;41:6-14.
  22. Kelleher CJ, Kreder KJ, Pleil AM, et al. Long-term health-related quality of life of patients receiving extended-release tolterodine for overactive bladder. Am J Manag Care 2002;8 (19 Suppl):S616-30.
  23. Sussman D, Garely A. Treatment of overactive bladder with once-daily extended-release tolterodine or oxybutynin: the antimuscarinic clinical effectiveness trial (ACET). Curr Med Res Opin 2002;18:177-84.
  24. Diokno AC, Appell RA, Sand PK, et al. Prospective, randomized, double-blind study of the efficacy and tolerability of the extended-release formulations of oxybutynin and tolterodine for overactive bladder: results of the OPERA trial. Mayo Clin Proc 2003;78:687-95.
  25. Appell RA. Clinical efficacy and safety of tolterodine in the treatment of overactive bladder: a pooled analysis. Urology 1997;50 (6A Suppl):90-6.

 
 
 
 
 
 
 
 
 
 
 
 
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