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Pharmacotherapy of overactive bladder in adults: a review of efficacy, tolerability, and quality of life

INTRODUCTION: Overactive bladder (OAB) is a prevalent condition that has a significant impact on quality of life. The usual treatment approach is both behavioral and pharmacological. The first-line pharmacological treatment commonly utilizes anticholinergic agents, which may be limited by their tole...

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Autores principales: Jayarajan, Jyotsna, Radomski, Sidney B
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3862648/
https://www.ncbi.nlm.nih.gov/pubmed/24400248
http://dx.doi.org/10.2147/RRU.S40034
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author Jayarajan, Jyotsna
Radomski, Sidney B
author_facet Jayarajan, Jyotsna
Radomski, Sidney B
author_sort Jayarajan, Jyotsna
collection PubMed
description INTRODUCTION: Overactive bladder (OAB) is a prevalent condition that has a significant impact on quality of life. The usual treatment approach is both behavioral and pharmacological. The first-line pharmacological treatment commonly utilizes anticholinergic agents, which may be limited by their tolerability, efficacy, and long-term compliance. Developments in elucidating the pathophysiology of OAB and alternative targets for pharmacological therapy have led to newer agents being developed to manage this condition. These agents include mirabegron and botulinum toxin, which have alternate mechanism of action and avoid the anticholinergic side effects. OBJECTIVES: To provide an update for clinicians managing OAB with an overview of the existing and newer medical options for OAB, including pharmacology, efficacy, side-effect profile, tolerability, and impact on patient quality of life. METHODS: PubMed and Medline were searched for randomized controlled drug trials in adults with OAB, meta-analyses of medical therapy for OAB, and individual drug names, including the keywords efficacy, tolerability, quality of life, and compliance. Nonhuman studies, pediatric trials, and those involving patients with neurogenic bladder dysfunction (with the exception of studies involving botulinum toxin A) were excluded. RESULTS: There is level 1, Grade A evidence to support the efficacy of anticholinergic drugs, botulinum toxin, and mirabegron for OAB. Long-term compliance with anticholinergic medications is limited. The mechanism of action, effectiveness, and side effects of these drugs are discussed, and where the data are available compared with other OAB medications. CONCLUSION: Most of the anticholinergic agents have comparative efficacies and core side-effect profiles, with individual variations relating to their muscarinic receptor selectivity, pharmacokinetics, and metabolism. Newer agents, with alternative sites of action, such as mirabegron and botulinum toxin, provide additional treatment options for patients intolerant to or inadequately treated with anticholinergics.
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spelling pubmed-38626482014-01-07 Pharmacotherapy of overactive bladder in adults: a review of efficacy, tolerability, and quality of life Jayarajan, Jyotsna Radomski, Sidney B Res Rep Urol Review INTRODUCTION: Overactive bladder (OAB) is a prevalent condition that has a significant impact on quality of life. The usual treatment approach is both behavioral and pharmacological. The first-line pharmacological treatment commonly utilizes anticholinergic agents, which may be limited by their tolerability, efficacy, and long-term compliance. Developments in elucidating the pathophysiology of OAB and alternative targets for pharmacological therapy have led to newer agents being developed to manage this condition. These agents include mirabegron and botulinum toxin, which have alternate mechanism of action and avoid the anticholinergic side effects. OBJECTIVES: To provide an update for clinicians managing OAB with an overview of the existing and newer medical options for OAB, including pharmacology, efficacy, side-effect profile, tolerability, and impact on patient quality of life. METHODS: PubMed and Medline were searched for randomized controlled drug trials in adults with OAB, meta-analyses of medical therapy for OAB, and individual drug names, including the keywords efficacy, tolerability, quality of life, and compliance. Nonhuman studies, pediatric trials, and those involving patients with neurogenic bladder dysfunction (with the exception of studies involving botulinum toxin A) were excluded. RESULTS: There is level 1, Grade A evidence to support the efficacy of anticholinergic drugs, botulinum toxin, and mirabegron for OAB. Long-term compliance with anticholinergic medications is limited. The mechanism of action, effectiveness, and side effects of these drugs are discussed, and where the data are available compared with other OAB medications. CONCLUSION: Most of the anticholinergic agents have comparative efficacies and core side-effect profiles, with individual variations relating to their muscarinic receptor selectivity, pharmacokinetics, and metabolism. Newer agents, with alternative sites of action, such as mirabegron and botulinum toxin, provide additional treatment options for patients intolerant to or inadequately treated with anticholinergics. Dove Medical Press 2013-12-06 /pmc/articles/PMC3862648/ /pubmed/24400248 http://dx.doi.org/10.2147/RRU.S40034 Text en © 2014 Jayarajan and Radomski. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Review
Jayarajan, Jyotsna
Radomski, Sidney B
Pharmacotherapy of overactive bladder in adults: a review of efficacy, tolerability, and quality of life
title Pharmacotherapy of overactive bladder in adults: a review of efficacy, tolerability, and quality of life
title_full Pharmacotherapy of overactive bladder in adults: a review of efficacy, tolerability, and quality of life
title_fullStr Pharmacotherapy of overactive bladder in adults: a review of efficacy, tolerability, and quality of life
title_full_unstemmed Pharmacotherapy of overactive bladder in adults: a review of efficacy, tolerability, and quality of life
title_short Pharmacotherapy of overactive bladder in adults: a review of efficacy, tolerability, and quality of life
title_sort pharmacotherapy of overactive bladder in adults: a review of efficacy, tolerability, and quality of life
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3862648/
https://www.ncbi.nlm.nih.gov/pubmed/24400248
http://dx.doi.org/10.2147/RRU.S40034
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