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Drugs for urinary incontinence may elevate risk of xerostomia in elderly

01 Nov 2017

Xerostomia and salivary gland hypofunction appear to be common side effects of elderly medication, particularly those for urinary incontinence, according to a recent study.

The research team performed a meta-analysis of 52 eligible papers, of which 33 were experimental studies, 19 were observational and cross-sectional, and six were pooled analyses. For inclusion, studies had to have an elderly sample and include comparator or control groups. Outcomes were xerostomia, hyposalivation or hypofunction of salivary glands.

Analysis of pooled data from 22 placebo-controlled randomized controlled trials revealed a statistically significant relationship between xerostomia and urological medications (odds ratio [OR], 5.91; 95 percent CI, 4.04 to 8.63; p<0.00001).

When the research team considered specific medications, they found that oxybutynin conferred the highest risk of dry mouth (OR, 18.85; 8.43 to 42.16; p<0.00001) followed by darifenacin (OR, 7.41; 2.87 to 19.15; p<0.0001). Fesoterodine (OR, 6.94; 3.59 to 13.43; p<0.00001) and tolterodine (OR, 4.82; 3.25 to 7.15; p<0.00001) were also significantly associated with a higher risk of dry mouth while mirabegron (OR, 1.17; 0.48 to 2.89; p=0.73) was not.

Antidepressant use was also significantly associated with xerostomia (OR, 4.74; 2.69 to 8.32; p<0.00001), with the specific drug duloxetine (OR, 6.02; 3.42 to 10.60; p<0.00001) having the largest risk. In contrast, escitalopram (OR, 2.19; 0.85 to 5.61; p=0.10) and doxepin (OR, 2.91; 0.30 to 28.31; p=0.36) were not associated with the risk of dry mouth.

Psycholeptics also significantly increased the risk of xerostomia more than placebo (OR, 2.59; 1.70 to 3.95; p<0.00001), with both eszopiclone (OR, 6.10; 1.34 to 27.80; p=0.02) and quetiapine (OR, 2.42; 1.56 to 3.74; p<0.0001) showing statistically significant associations. 

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Women with neuropathic bladder (NB) and paediatric lower urinary tract reconstruction (LUTR) are at increased risk of developing complications during pregnancy and caesarean delivery (CD), with those having prolonged labour, prior CD or a history of noncompliance having the worst complications, according to a study.