Effects of fesoterodine: A Synthesis of Findings from 22 Studies

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Original Abstract of the Article

Major Findings

Fesoterodine is a medication approved for the treatment of overactive bladder (OAB) in adults and neurogenic detrusor overactivity (NDO) in pediatric patients. 8 It works by blocking muscarinic receptors in the bladder, which helps to reduce bladder contractions and improve symptoms of OAB. Studies have shown that fesoterodine can be effective in treating OAB symptoms such as urinary urgency, frequency, and incontinence. 5 10 Fesoterodine is generally well-tolerated, but it can cause side effects such as dry mouth, constipation, and blurred vision. 17 14 9 The safety of fesoterodine in older adults has been evaluated in several studies, and the drug appears to be safe and effective in this population. 19 3 However, some studies have raised concerns about potential cognitive side effects, particularly in patients with dementia. 20 15 2 6

Benefits and Risks

Benefit Summary

Fesoterodine can be effective in treating overactive bladder symptoms such as urinary urgency, frequency, and incontinence. 5 10 It appears to be safe and effective in older adults, though it might require close monitoring. 19 3

Risk Summary

Common side effects of fesoterodine include dry mouth, constipation, and blurred vision. 17 14 9 Some studies have raised concerns about potential cognitive side effects, particularly in patients with dementia. 20 15 2 6

Comparison Across Studies

Similarities

Most studies have shown that fesoterodine can be effective in treating OAB symptoms. 5 10 Common side effects reported include dry mouth, constipation, and blurred vision. 17 14 9

Differences

Studies have varied in the dosage, delivery method, and frequency of side effects reported. 4 22 Research comparing fesoterodine to other OAB medications has also shown mixed results. 22

Consistency and Contradictions

Many studies consistently show fesoterodine is effective in treating OAB symptoms. 5 10 However, the frequency and severity of side effects can vary. 17 14 9

Considerations for Real-World Application

Fesoterodine can be an effective treatment for OAB, but it’s important to be aware of potential side effects. 17 14 9 Close monitoring is especially important for older adults and patients with dementia due to concerns about cognitive side effects. 20 15 2 6

Limitations of Current Research

While there have been many studies on the effects and safety of fesoterodine, further research is needed to better understand long-term safety and efficacy in specific patient groups. 14

Future Research Directions

Further research is needed to understand the long-term safety and efficacy of fesoterodine in specific patient groups. 14 More comparative research comparing fesoterodine to other OAB medications is needed. 22

Conclusion

Fesoterodine can be an effective treatment for OAB, but it’s important to be aware of potential side effects. 17 14 9 Close monitoring is especially important for older adults and patients with dementia due to concerns about cognitive side effects. 20 15 2 6 If you are taking fesoterodine, make sure to follow your doctor’s instructions and report any side effects promptly.

Literature analysis of 22 papers
Positive Content
18
Neutral Content
1
Negative Content
3
Article Type
6
3
3
7
22
1.

Thorough QT study of the effect of fesoterodine on cardiac repolarization.

Author: MalhotraB, WoodN, SachseR, GandelmanK

Fesoterodine safe

The study found that fesoterodine was not associated with QTc prolongation or other ECG abnormalities at either therapeutic or supratherapeutic doses.

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.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

Evaluation of cognitive function in healthy older subjects treated with fesoterodine.

Author: KayGary G, MaruffPaul, ScholfieldDavid, MalhotraBimal, WhelanLaurence, DarekarAmanda, MartireDiane L

No cognitive impairment
Dry mouth

Fesoterodine 4 and 8 mg once daily had no statistically significant effects on cognitive function, including memory, in healthy older adults. However, alprazolam 1 mg produced statistically significant deterioration.

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

3.

Fesoterodine: Pharmacological properties and clinical implications.

Author: GaméXavier, PeyronnetBenoit, CornuJean-Nicolas

Improved overactive bladder symptoms

This systematic review examined fesoterodine's pharmacological properties to explain its clinical benefits for overactive bladder (OAB) in general and elderly populations. The review found that fesoterodine's high affinity for both M2 and M3 muscarinic receptors, poor blood-brain barrier penetration, lack of hepatic first-pass activation, and extended-release formulation contribute to its good balance between efficacy and tolerability.

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

4.

On-demand use of fesoterodine: a new paradigm for extended release antimuscarinics.

Author: BozkurtIbrahim Halil, SefikErtugrul, CelikSerdar, YesilovaArda, KorasOmer, DegirmenciTansu

Overactive bladder improvement
Constipation
Dry mouth

On-demand use of fesoterodine 4 mg showed similar efficacy to continuous use with fewer adverse events in patients with overactive bladder (OAB).

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

5.

Comparative assessment of efficacy and safety of approved oral therapies for overactive bladder: a systematic review and network meta-analysis.

Author: HeWenjuan, HuangGuangliang, CuiWenyan, TianYunfei, SunQian, ZhaoXiaojuan, ZhaoYonghong, LiDan, LiuXiuju

Improved bladder function
Constipation
Dry mouth
Headache
Hypertension
Urinary tract infection

Solifenacin showed the best efficacy for overactive bladder. Most anticholinergic drugs were more likely to cause dry mouth and constipation, with lower doses being better tolerated. The choice of drugs should be tailored to the patient's specific situation.

Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
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

6.

Cognitive effects of individual anticholinergic drugs: a systematic review and meta-analysis.

Author: NaseriAmirreza, Sadigh-EteghadSaeed, Seyedi-SahebariSepideh, HosseiniMohammad-Salar, HajebrahimiSakineh, Salehi-PourmehrHanieh

Scopolamine risk

This systematic review investigated the effects of individual anticholinergics (ACs) on cognitive function. Scopolamine was associated with reduced recognition, immediate recall, matching to sample, delayed recall, complex memory tasks, free recall, cognitive function, attention, and digit span. Glycopyrrolate, trospium, tolterodine, darifenacin, fesoterodine, tiotropium, and ipratropium were not associated with cognitive decline.

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

7.

Oral anticholinergic drugs versus placebo or no treatment for managing overactive bladder syndrome in adults.

Author: StoniuteAkvile, MadhuvrataPriya, StillMadeleine, Barron-MillarEvelyn, NabiGhulam, OmarMuhammad Imran

OAB treatment

Overactive bladder (OAB) affects around 16% of adults, with prevalence increasing with age. Symptoms include urgency, frequency, and urge incontinence. Anticholinergic drugs are commonly used to treat OAB. This is an update of a Cochrane Review first published in 2002 and last updated in 2006.

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.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

Population Pharmacokinetic and Pharmacodynamic Modeling of Fesoterodine in Pediatric Patients with Neurogenic Detrusor Overactivity.

Author: SanoYamato, ShojiSatoshi, ShahinMohamed, SweeneyKevin, DarekarAmanda, MalhotraBimal K

Neurogenic detrusor overactivity treatment
Overactive bladder treatment

This study aimed to characterize the population pharmacokinetics of 5-hydroxymethyl tolterodine (5-HMT), the active metabolite of fesoterodine, in pediatric patients with overactive bladder (OAB) or neurogenic detrusor overactivity (NDO) following administration of fesoterodine.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

Characteristics of medication-induced xerostomia and effect of treatment.

Author: ItoKayoko, IzumiNaoko, FunayamaSaori, NohnoKaname, KatsuraKouji, KanekoNoboru, InoueMakoto

Xerostomia treatment

This study analyzes the actual status of patients with medication-induced xerostomia and investigates factors associated with its improvement. Xerostomia, or dry mouth, is a common side effect of medications and can sometimes lead to discontinuation of the medication. This study aims to understand the experience of patients with medication-induced xerostomia and identify potential factors that contribute to its improvement.

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

10.

Fesoterodine treatment of pediatric patients with neurogenic detrusor overactivity: A 24-week, randomized, open-label, phase 3 study.

Author: KittaTakeya, DarekarAmanda, MalhotraBimal, ShahinMohamed H, JonesPhilip, LindsayMonica, MallenSharon, NietoAlejandra, CrookTim J

Improved incontinence
Increased bladder capacity
Dry mouth

Fesoterodine is safe and effective in treating neurogenic detrusor overactivity (NDO) in children aged 6 to 18 years. This open-label phase 3 study in 2 pediatric cohorts showed fesoterodine 4 and 8 mg and fesoterodine 2 and 4 mg BIC treatment resulted in significant increases from baseline in maximum cystometric bladder capacity (MCC) at Week 12. Fesoterodine 4 and 8 mg and fesoterodine 4 mg BIC led to improvements in secondary efficacy endpoints. No detrimental effects on visual accommodation or acuity, or on cognitive function or behavior were observed.

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

12.

Atomoxetine and fesoterodine combination improves obstructive sleep apnoea severity in patients with milder upper airway collapsibility.

Author: MessineoLudovico, Taranto-MontemurroLuigi, CalianeseNicole, GellLaura K, AzarbarzinAli, LabarcaGonzalo, VenaDan, YangHyung Chae, WangTsai-Yu, WellmanAndrew, SandsScott A

Genioglossus activity increase
OSA reduction
Side effects

Atomoxetine is a medication for attention-deficit/hyperactivity disorder (ADHD). It has been shown to improve sleep apnoea when combined with oxybutynin, a medication for overactive bladder. This study investigates whether a combination of atomoxetine and a newer medication for overactive bladder, fesoterodine, can also help improve sleep apnoea.

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.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

13.

Effects of β3 Agonists and Anticholinergic Drugs on Defecation in Patients With Overactive Bladder.

Author: ItoHidenori, MatsuoTomohiro, KurataHiroki, MasatoMasahito, MitsunariKensuke, OhbaKojiro, MiyataYasuyoshi

Constipation

Constipation is a common side effect of drugs for overactive bladder (OAB). This study aimed to evaluate and compare the effects of three commonly used β3 agonists and anticholinergic drugs on defecation status in patients with OAB.

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

Language : English

14.

Adverse events related to antimuscarinics and beta-3-agonist: "real-life" data from the Eudra-Vigilance Database.

Author: DE NunzioCosimo, NacchiaAntonio, GravinaCarmen, TurchiBeatrice, GalloGiacomo, TrucchiAlberto, DI GiacomoFerdinando, DisabatoGiuseppe, FrancoAntonio, RovestiLorenzo, LombardoRiccardo, CicioneAntonio, TubaroAndrea

Effective treatment for OAB
Cognitive disorder
Hypertension
Urinary retention

Antimuscarinics and beta-3-agonists are commonly used to treat overactive bladder (OAB), but can cause adverse events. Urinary retention was more common with fesoterodine and tolterodine, while mirabegron was associated with a higher risk of hypertension.

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

Language : English

15.

Dementia Associated with Anticholinergic Drugs Used for Overactive Bladder: A Nested Case-Control Study Using the French National Medical-Administrative Database.

Author: MalcherMarie France, DroupyStephane, BerrClaudine, ZiadAbdelkrim, HuguetHelena, FaillieJean-Luc, SerrandChris, MuraThibault

Increased dementia risk

Anticholinergic drugs used to treat overactive bladder (OAB) were associated with an increased risk of incident dementia in older patients. The risk was particularly marked for oxybutynin and solifenacin.

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

Language : English

16.

On-demand use of fesoterodine: a new paradigm for extended release antimuscarinics.

Author: BozkurtIbrahim Halil, SefikErtugrul, CelikSerdar, YesilovaArda, KorasOmer, DegirmenciTansu

Overactive bladder improvement
Constipation
Dry mouth

On-demand use of fesoterodine 4 mg showed similar efficacy to continuous use with fewer adverse events in patients with overactive bladder (OAB).

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

18.

Comprehensive overview of the available pharmacotherapy for the treatment of non-neurogenic overactive bladder in children.

Author: RamsaySophie, LapointeÉlisabeth, BolducStéphane

Improve quality of life

This review discusses the management of overactive bladder (OAB) in children. Conservative measures should be the primary treatment approach. When conservative management fails, pharmacological options should be considered.

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

19.

Safety and Tolerability of Fesoterodine in Older Adult Patients with Overactive Bladder.

Author: HeesakkersJohn, Te DorsthorstManon, WaggAdrian

Flexible dosing
Improved OAB symptoms
Reduced CNS effects

This article reviewed available published studies and found that fesoterodine is a safe and effective treatment for overactive bladder (OAB) in older patients. Fesoterodine offers flexible dosing and can be used in patients with mild or moderate hepatic or renal insufficiency.

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

20.

Receipt of Overactive Bladder Drugs and Incident Dementia: A Population-based Case-control Study.

Author: MattaRano, GomesTara, JuurlinkDavid, JarviKeith, HerschornSender, NamRobert K

Dementia risk

Older adults taking solifenacin or darifenacin for overactive bladder (OAB) had an increased risk of dementia compared to those taking mirabegron. Solifenacin and darifenacin taken in the 6 months before dementia diagnosis, and solifenacin, darifenacin, tolterodine, or fesoterodine taken in the year before dementia diagnosis, increased the risk. Oxybutynin and trospium were not associated with dementia.

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

21.

Choosing the Most Efficacious and Safe Oral Treatment for Idiopathic Overactive Bladder: A Systematic Review and Network Meta-analysis.

Author: MostafaeiHadi, Salehi-PourmehrHanieh, JilchSandra, CarlinGreta Lisa, MoriKeiichiro, QuhalFahad, PradereBenjamin, GrossmannNico C, LaukhtinaEkaterina, SchuettfortVictor M, AydhAbdulmajeed, Sari MotlaghReza, KönigFrederik, RoehrbornClaus G, KatayamaSatoshi, RajwaPawel, HajebrahimiSakineh, ShariatShahrokh F

Improved bladder function
Reduced urinary symptoms
Gastrointestinal side effects

A network meta-analysis of 54 randomized controlled trials involving patients with idiopathic overactive bladder (IOAB) compared the efficacy of oral antimuscarinics and β-adrenoceptor agonists, considering adverse events. The most efficacious agents for reducing various overactive bladder symptoms varied depending on the specific symptom, and gastrointestinal problems were the most common adverse events. The findings highlight the importance of shared decision-making with patients to select the most appropriate treatment based on individual symptoms and tolerability.

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.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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