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Propiverine vs oxybutynin for treating neurogenic detrusor overactivity in children and adolescents: results of a multicentre observational cohort study
Author(s) -
Madersbacher Helmut,
Mürtz Gerd,
Alloussi Schahnaz,
Domurath Burghard,
Henne Thomas,
Körner Iris,
Niedeggen Andreas,
Nounla Joseph,
Pannek Jürgen,
SchulteBaukloh Heinrich,
SchultzLampel Daniela,
Bock Paul,
Strugala Gerhard
Publication year - 2009
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2008.08093.x
Subject(s) - oxybutynin , medicine , tolerability , retrospective cohort study , overactive bladder , anesthesia , adverse effect , urology , alternative medicine , pathology
OBJECTIVE To compare, in a retrospective observational cohort study, the efficacy, tolerability, safety and clinical effectiveness of propiverine and oxybutynin in children and adolescents with neurogenic detrusor overactivity (NDO). PATIENTS AND METHODS In all, 255 children and adolescents (aged 1–18 years) with NDO (199 myelomeningocele, 46 spinal cord injury, 10 other diagnoses) were enrolled at 14 study centres. To evaluate the efficacy of propiverine and oxybutynin, urodynamic and clinical variables were assessed before and after at least 12 month of the antimuscarinic agents administered at variable doses. RESULTS In all, 127 patients given propiverine and 128 given oxybutynin were enrolled. The primary efficacy outcome, i.e. reductions in urodynamically assessed individual maximum detrusor pressure (P detmax ), was assumed to indicate success in 74.2% of those on propiverine vs 49.6% on oxybutynin. The mean P detmax was significantly reduced during treatment, from 59.8 to 36.7 cmH 2 O in the propiverine and from 65.2 to 54.9 cmH 2 O in the oxybutynin groups. The mean maximum cystometric bladder capacity increased from 146 to 242 mL in the propiverine and from 222 to 310 mL in the oxybutynin group. Propiverine was better tolerated than oxybutynin, having fewer adverse drug reactions (9.4% vs 17.2%, odds ratio 2.04), and for its severity grades and premature treatment termination (none vs 11 cases). CONCLUSION In this non‐interventional study, reflecting ‘real‐life’ clinical practice, comparing the efficacy, tolerability and safety of propiverine and oxybutynin in children and adolescents with NDO, propiverine was at least as effective as oxybutynin, but better tolerated, resulting in superior clinical effectiveness than for oxybutynin.