Effects of darifenacin: A Synthesis of Findings from 26 Studies

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Original Abstract of the Article

Major Research Findings

Darifenacin is an antimuscarinic drug used to treat overactive bladder (OAB). Several studies have reported that darifenacin is effective in improving OAB symptoms, particularly urgency, frequency, and incontinence. 15 , 12 Darifenacin is thought to improve these symptoms by suppressing bladder contractions. 20 Furthermore, darifenacin has been suggested to have a protective effect on bladder remodeling. 20 On the other hand, darifenacin can cause side effects such as dry mouth, constipation, and blurred vision. 26 It has also been reported to be associated with cognitive decline and an increased risk of death. 26 , 22

Some studies suggest that darifenacin is more effective than other antimuscarinic drugs. 18 It has also been suggested that darifenacin may have less impact on cognitive function compared to other antimuscarinics. 23 However, these studies do not clearly demonstrate that darifenacin is superior to other antimuscarinics. 23 Furthermore, it has been suggested that darifenacin should be used with particular caution in the elderly and in patients with cognitive impairment. 23 , 22

Benefits and Risks

Benefits Summary

Darifenacin is effective in improving overactive bladder (OAB) symptoms, particularly urgency, frequency, and incontinence. 15 , 12 Furthermore, darifenacin has been suggested to have a protective effect on bladder remodeling. 20

Risks Summary

Darifenacin can cause side effects such as dry mouth, constipation, and blurred vision. 26 It has also been reported to be associated with cognitive decline and an increased risk of death. 26 , 22 It should be used with particular caution in the elderly and in patients with cognitive impairment. 23 , 22

Comparison between Studies

Similarities in Studies

Many studies have reported that darifenacin is effective in improving OAB symptoms. 15 , 12 , 18 It has also been suggested that darifenacin is more effective than other antimuscarinic drugs. 18 However, not all studies have found an effect of darifenacin. 18

Differences in Studies

The effects of darifenacin can vary depending on the study. 18 This may be due to various factors such as the age, sex, severity of OAB, and use of other medications of the study subjects. 18 Also, while some studies suggest that darifenacin is more effective than other antimuscarinics, 18 other studies suggest that the effect of darifenacin is not significantly different from other antimuscarinics. 18

Consistency and Contradictions in Results

Many studies have confirmed that darifenacin is effective in improving OAB symptoms. 15 , 12 , 18 However, a clear conclusion has not been reached on how much superior darifenacin is compared to other antimuscarinic drugs. 18 Furthermore, darifenacin can cause side effects such as dry mouth, constipation, and blurred vision. 26 It has also been reported to be associated with cognitive decline and an increased risk of death. 26 , 22 Therefore, the use of darifenacin, especially in the elderly and in patients with cognitive impairment, should be carefully considered. 23 , 22

Practical Considerations

Darifenacin is an effective drug for improving overactive bladder (OAB) symptoms, particularly urgency, frequency, and incontinence. 15 , 12 However, darifenacin can cause side effects such as dry mouth, constipation, and blurred vision. 26 It has also been reported to be associated with cognitive decline and an increased risk of death. 26 , 22 Therefore, the use of darifenacin, especially in the elderly and in patients with cognitive impairment, should be carefully considered. 23 , 22

Limitations of Current Research

Research on the effects of darifenacin is still insufficient. 18 In particular, a clear conclusion has not been reached on how much superior darifenacin is compared to other antimuscarinic drugs. 18 Also, the effects of long-term use of darifenacin are not yet fully understood. 8

Future Research Directions

More research on the effects of darifenacin is needed. 18 In particular, further research is needed on how much superior darifenacin is compared to other antimuscarinic drugs, 18 and on the effects of long-term use of darifenacin. 8 Furthermore, further research is needed on the impact of darifenacin on cognitive function. 26

Conclusion

Darifenacin is an effective drug for improving overactive bladder (OAB) symptoms, but there is a risk of side effects. 15 , 12 , 26 When using darifenacin, it is important to consult with your doctor and understand the risks and benefits of side effects before using it cautiously. 26

Literature analysis of 26 papers
Positive Content
16
Neutral Content
3
Negative Content
7
Article Type
1
3
6
8
26
1.

MACC1 mediates acetylcholine-induced invasion and migration by human gastric cancer cells.

Author: YangTing, HeWanming, CuiFei, XiaJianling, ZhouRui, WuZhenzhen, ZhaoYang, ShiMin

GC cell invasion/migration

Acetylcholine (ACh) promotes gastric cancer (GC) cell invasion and migration via the M3 muscarinic receptor (M3R) and the oncogene MACC1. The M3R antagonist darifenacin inhibited GC cell activity, suggesting that GC cells secrete endogenous ACh, which then acts in an autocrine fashion to promote GC cell migration/invasion.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Discontinuation of treatment using anticholinergic medications in patients with urinary incontinence.

Author: KalderMatthias, PantazisKonstantinos, DinasKonstantinos, AlbertUte-Susann, HeilmaierChristina, KostevKarel

High discontinuation rates

Patients with urinary incontinence showed high discontinuation rates for anticholinergics. Discontinuation rates were higher for men, younger patients, and those treated in general and gynecologic practices.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

Risk of type 2 diabetes mellitus by antimuscarinic agents among adult females receiving care in the military health system.

Author: SeligDaniel J, BrownAaron J, DeLucaJesse P, KressAdrian T, LivezeyJeffrey R, OliverThomas G, PorElaine D, Thelus JeanRosenie

Reduced urinary incontinence
Type 2 diabetes

Exposure to antimuscarinic medications, particularly tolterodine, was associated with an increased risk of type 2 diabetes mellitus in women. Clinicians should consider this potential risk when prescribing antimuscarinic medications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.

Language : English

5.

Adverse events and treatment discontinuations of antimuscarinics for the treatment of overactive bladder in older adults: A systematic review and meta-analysis.

Author: VouriScott Martin, KebodeauxClark D, StrangesPaul M, TeshomeBesu F

Anticholinergic effects

This review aims to evaluate adverse events (AEs) and treatment discontinuations in adults aged 65 years or older taking antimuscarinics for overactive bladder (OAB). It specifically focuses on the elderly population, who are at higher risk for anticholinergic AEs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

6.

Muscarinic acetylcholine receptor 3 mediates vagus nerve-induced gastric cancer.

Author: WangLinjun, XuJianghao, XiaYiwen, YinKai, LiZheng, LiBowen, WangWeizhi, XuHao, YangLi, XuZekuan

Inhibited gastric cancer development

This study investigated the effects of the vagus nerve on gastric cancer (GC) development in a mouse model. Vagotomy inhibited GC development, suggesting a key role of the muscarinic acetylcholine receptor 3 (M3) in mediating these effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Role of M2 and M3 muscarinic acetylcholine receptor subtypes in activation of bladder afferent pathways in spinal cord injured rats.

Author: MatsumotoYoshihiro, MiyazatoMinoru, YokoyamaHitoshi, KitaMasafumi, HiraoYoshihiko, ChancellorMichael B, YoshimuraNaoki

Detrusor overactivity

The M2 muscarinic acetylcholine receptor (mAChR) subtype plays an important role in bladder afferent activation, which enhances detrusor overactivity in rats with spinal cord injury (SCI).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

Long-term adherence to antimuscarinic therapy in everyday practice: a systematic review.

Author: VeenboerPaul W, BoschJ L H Ruud

Improved adherence
Side effects

Long-term adherence to antimuscarinic drugs is poor, highlighting the need for strategies to improve patient compliance and persistence with treatment regimens.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

10.

Appropriateness of oral drugs for long-term treatment of lower urinary tract symptoms in older persons: results of a systematic literature review and international consensus validation process (LUTS-FORTA 2014).

Author: OelkeMatthias, BecherKlaus, Castro-DiazDavid, Chartier-KastlerEmmanuel, KirbyMike, WaggAdrian, WehlingMartin

Improved LUTS symptoms
Drug interactions

Dutasteride, fesoterodine, and finasteride were classified as beneficial for older persons. The use of most other drugs for LUTS in older persons is questionable or should be avoided.

Consensus Development ConferenceA conference organized by the National Institutes of Health (NIH) to develop consensus and recommendations on medical issues.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

14.

Comparative effectiveness of interventions for managing postoperative catheter-related bladder discomfort: a systematic review and network meta-analysis.

Author: HurMin, ParkSun-Kyung, YoonHyun-Kyu, YooSeokha, LeeHyung-Chul, KimWon Ho, KimJin-Tae, KuJa Hyeon, BahkJae-Hyon

CRBD management

This study aims to assess the comparative effectiveness of various drugs and interventions used to manage catheter-related bladder discomfort (CRBD) in patients undergoing urological surgery.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

15.

Time-to-effect with darifenacin in overactive bladder: a pooled analysis.

Author: KhullarVik, FooteJenelle, SeifuYodit, EgermarkMathias

Rapid onset of effect
Reduced OAB symptoms

Darifenacin, a medication for overactive bladder (OAB), was found to be effective as early as 6 to 8 days after starting treatment. Both 7.5 mg and 15 mg doses significantly reduced OAB symptoms throughout the study, including micturition frequency, incontinence episodes, and urgency.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

16.

New pharmacological approaches to the cholinergic system: an overview on muscarinic receptor ligands and cholinesterase inhibitors.

Author: GreigNigel H, RealeMarcella, TataAda M

Alzheimer's disease treatment
Analgesic effect
Cholinergic system modulation
Sjogren's disease treatment
Tumor progression arrest

This review discusses the cholinergic system and its modulation by pharmacological drugs. It focuses on recent developments in muscarinic receptor ligands and cholinesterase inhibitors, highlighting their potential in treating nervous system diseases, including Alzheimer's disease, Sjogren's syndrome, and cancer.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., IntramuralFunding provided by the NIH for research projects within the NIH.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

18.

Comparative efficacy and tolerability of solifenacin 5 mg/day versus other oral antimuscarinic agents in overactive bladder: A systematic literature review and network meta-analysis.

Author: NazirJameel, KelleherCon, AballéaSamuel, MamanKhaled, HakimiZalmai, MankowskiColette, OdeyemiIsaac

Efficacy
Reduced dry mouth
No significant difference

Solifenacin 5 mg/day is at least as effective as other common antimuscarinic agents for overactive bladder (OAB) and is more effective than tolterodine 4 mg/day in reducing incontinence and urgency urinary incontinence (UUI) episodes. Network meta-analysis also showed that solifenacin 5 mg/day is associated with a lower risk of dry mouth compared to several other antimuscarinic agents.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

19.

Management of OAB in those over age 65.

Author: NatalinRicardo, LorenzettiFabio, DambrosMiriam

Overactive bladder treatment
Quality of life
Cognitive side effects

Antimuscarinic medications are safe and effective for treating overactive bladder (OAB) in older adults. Lifestyle modifications and behavioral therapy can also help.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

22.

Risk of Mortality Associated with Non-selective Antimuscarinic medications in Older Adults with Dementia: a Retrospective Study.

Author: KachruNandita, HolmesHolly M, JohnsonMichael L, ChenHua, AparasuRajender R

Increased mortality

The study found that non-selective antimuscarinics were associated with a 50% higher risk of mortality within 180 days of use compared to selective antimuscarinics in older adults with dementia and overactive bladder (OAB). Given the safety concerns, optimizing the use of non-selective antimuscarinics in OAB management for older patients with dementia is crucial.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

23.

Differential Prescribing of Antimuscarinic Agents in Older Adults with Cognitive Impairment.

Author: VouriScott Martin, SchootmanMario, StropeSeth A, BirgeStanley J, OlsenMargaret A

Cognitive impairment

Older adults with documented cognitive impairment were less likely to initiate oral oxybutynin than other antimuscarinic medications. However, the use of oral oxybutynin has increased over time, potentially due to cost considerations.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

24.

A comprehensive SARS-CoV-2 genomic analysis identifies potential targets for drug repurposing.

Author: AnandNithishwer Mouroug, LiyaDevang Haresh, PradhanArpit Kumar, TayalNitish, BansalAbhinav, DonakondaSainitin, JainarayananAshwin Kumar

COVID-19 treatment

This study identified conserved genes in SARS-CoV-2, including NSP10, Nucleoprotein, Plpro, and 3CLpro, which are potential drug targets. Molecular dynamics simulations identified potential drugs for further investigation, including darifenacin, nebivolol, bictegravir, alvimopan, and irbesartan.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

25.

Benefits and harms of pharmacologic treatment for urinary incontinence in women: a systematic review.

Author: ShamliyanTatyana, WymanJean F, RamakrishnanRema, SainfortFrançois, KaneRobert L

Restored continence
Adverse effects

Drugs for urgency urinary incontinence in women showed similar small benefits. Continence was restored in 130 out of 1000 treated women with fesoterodine, 85 with tolterodine, 114 with oxybutynin, 107 with solifenacin, and 114 with trospium.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

26.

Influence of antimuscarinic therapy on cognitive functions and quality of life in geriatric patients treated for overactive bladder.

Author: EsinEce, ErgenAli, CankurtaranMustafa, YavuzBurcu Balam, HalilMeltem, UlgerZekeriya, YeşilYusuf, KuyumcuMehmet Emin, OzcanMunevver, CankurtaranEylem, AriogulServet

OAB treatment
Cognitive decline

This study aims to evaluate the impact of antimuscarinic treatment on cognitive functions, depression, and quality of life (QOL) in patients with overactive bladder (OAB). Considering the age-related increase in OAB and cognitive decline, especially in Alzheimer's disease patients, the study explores potential risks associated with antimuscarinic treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : English

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