EFFECTS OF TERODILINE ON URINARY-INCONTINENCE AMONG OLDER NONINSTITUTIONALIZED WOMEN

Objective: To determine the effectiveness of terodiline, a drug with c alcium antagonist and anticholinergic properties, on the frequency of incontinence in older non-institutionalized women. Design: Randomized, placebo-controlled, parallel-group, double-blind trial. Setting: Twel ve outpatient clinics across the United States affiliated with program s in either geriatrics, gynecology, or urology. Participants: Ninety-e ight women, age 60 or older, with symptoms of urge incontinence and se lf-reported frequency of incontinence four or more times per week and involuntary bladder contractions on dual-channel water cystometry. Mai n Outcome Measures: Self-reported urinary frequency urgency number of incontinence episodes, and number of heavily soaked pads. Results: Eig hty-one women, average age 71, completed the trial, 40 in the active d rug group, 41 in the placebo group. Incontinence frequency and the num ber of heavily soaked pads were reduced in the active drug group by 64 % and 55%, respectively, and by 21% (P = 0.002) and 9% (P = 0.04) in t he placebo group. No patients dropped out due to adverse effects. An i ntention-to-treat analysis of all 98 patients yielded the same conclus ion. Conclusion: Terodiline is highly effective in reducing incontinen ce in older, noninstitutionalized women with urge incontinence. Becaus e of its potential association with polymorphic ventricular tachycardi a (torsades de pointes), terodiline must undergo further testing to de fine its safety before it can be recommended for clinical use in the i ncontinent geriatric population.