Fesoterodine improves nocturnal urgency in patients with overactive bladder syndrome
Treatment with fesoterodine shows efficacy in patients with nocturnal urgency secondary to overactive bladder syndrome and low nocturnal bladder capacity with a mismatch between nocturnal urine production and bladder capacity, reports a recent study.
To identify which bladder diary parameters predict the response to fesoterodine in patients with nocturnal urgency, a 2-week, single-blind placebo run-in was conducted, followed by 1:1 double-blind randomization to 12 weeks of fesoterodine or placebo.
Researchers analysed bladder diary parameter changes from baseline to week 12, including the actual number of night voids (total number of nocturia episodes), maximum voided volume, nocturnal bladder capacity, Nocturnal Bladder Capacity Index (NBCi; actual number of night voids – nocturnal urine volume/maximum voided volume – 1), nocturnal urine volume, the nocturia index (nocturnal urine volume/maximum voided volume) and the nocturnal polyuria index (nocturnal urine volume/24-hour volume). Overactive Bladder Questionnaire (OAB-q) changes were also analysed.
A linear relationship existed between the likelihood of being a responder for NBCi and the nocturia index. There was a substantial reduction in nocturnal urine volume compared with baseline among responders (‒181.7 ml; p<0.01). No significant change in maximum voided volume relative to baseline was observed in either of the treatment groups.
Responders had a significant decrease in NBCi (‒0.82) and the nocturia index (‒0.61; p<0.01 for each). They also showed improvements in the OAB-q concern, coping, sleep, bother and total score metrics.
“Symptom improvement appears to be mediated by increases in typical rather than maximum nocturnal voided volumes,” according to researchers, adding that symptom improvement correlated with enhanced quality of life.