Tolterodine - A new drug for the treatment of urge incontinence. Clinical and urodynamic efficacy and comparison with oxybutynin

The urodynamic effects of tolterodine (Detrusitol(R)) and its efficacy and tolerability in comparison with oxybutynin were investigated in patients wi th an overactive bladder in two multicentre, multinational, randomised, dou ble-blind, placebo-controlled studies. Patients were treated with tolterodi ne 1 or 2 mg twice daily or placebo for 4 weeks (242 patients, urodynamic p arameters), or received tolterodine (2 mg twice daily), oxybutynin (5 mg th ree times daily) or placebo for 12 weeks (293 patients, clinical parameters ). After 4 weeks' treatment, tolterodine 2 mg twice daily significantly inc reased, volume at first contraction and maximum cystometric capacity. After 12 weeks' treatment, the effect of tolterodine in reducing micturition fre quency and urge incontinence episodes was significantly greater than that o f placebo and statistically equivalent to oxybutynin treatment. Dry mouth w as the most common adverse event and was reported with greater frequency an d intensity among patients receiving oxybutynin than those receiving tolter odine or placebo. In conclusion, tolterodine is effective in improving urod ynamic parameters in patients with overactive bladder. Furthermore, toltero dine is better tolerated than oxybutynin and has comparable clinical effica cy.