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. 2019 Dec;14(4):377-384.
doi: 10.1007/s11884-019-00562-3. Epub 2019 Nov 25.

Advances in pharmacotherapy for the treatment of overactive bladder

Caitlyn E Painter  1 , Anne M Suskind  2
Affiliations

Advances in pharmacotherapy for the treatment of overactive bladder

Caitlyn E Painter et al. Curr Bladder Dysfunct Rep. 2019 Dec.

Abstract

Purpose of review: To present the current literature on the pharmacologic management of overactive bladder, including combination therapies, agents still in clinical development, and special considerations related to individuals with cognitive decline, frailty and cardiovascular risk.

Recent findings: Combination therapy is shown to be more effective than monotherapy, without additional side effects. Preliminary studies on novel treatment methods, including new medications, as well was novel use of established medications, demonstrates improved efficacy with a favorable side effect profile. Investigation into new target pathways may be an area for future pharmacologic development. Special consideration should be given when prescribing anti-muscarinic medication in the frail adult population. Overactive bladder has been associated with frailty and anti-muscarinic medications have been associated with the worsening cognitive decline.

Summary: Combination therapy is a safe and effective alternative to patients with refractory overactive bladder. Caution should be taken in prescribing medications for the frail older adult, and alternative first- and third-line treatments should be considered. Future studies should involve long term data on safety and outcomes stratified by age with objective measurements of cognition and frailty.

Keywords: anti-muscarinic; beta-agonist; frailty; overactive bladder; pharmacotherapy.

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Conflict of interest statement

Conflict of Interest Caitlyn Painter has no conflicts of interest. Anne Suskind is a consultant for Acoustic Wave Cell Therapy, Inc.

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