Long-term safety, tolerability and efficacy of flexible-dose fesoterodine in elderly patients with overactive bladder: open-label extension of the SOFIA trial

Neurourol Urodyn. 2014 Jan;33(1):106-14. doi: 10.1002/nau.22383. Epub 2013 Mar 4.

Abstract

Aims: To assess the long-term safety, tolerability, and efficacy of flexible-dose fesoterodine in elderly patients with OAB.

Methods: Patients aged ≥65 years who completed a 12-week, randomized, double-blind, placebo-controlled trial were eligible for the 12-week, open-label (OL) extension phase. Patients who received double-blind placebo started on fesoterodine 4 mg and could increase to 8 mg after 4 or 8 weeks of OL treatment, while fesoterodine-treated patients continued on their double-blind dose; only one dose escalation or de-escalation was permitted. Discontinuations and adverse events (AEs) were monitored, and patients completed 3-day bladder diaries and patient-reported outcomes at the beginning and end of the 12-week OL phase.

Results: Six hundred fifty-four patients entered the 12-week OL extension (mean age 72 years; 52% women). AEs were reported by 30.7% and 48.1% of patients who had received double-blind fesoterodine and placebo, respectively; 1.9% and 9.4%, discontinued due to AEs, respectively. Patients who received double-blind fesoterodine maintained their efficacy response. After 12 weeks of OL treatment, efficacy outcomes in patients who received double-blind placebo were similar to those who had received double-blind fesoterodine. On average, the efficacy response was maintained for the duration of the study.

Conclusions: Fesoterodine was well tolerated and improvements in OAB symptoms and quality of life measures were not diminished with longer-term treatment of patients aged ≥65 years.

Trial registration: ClinicalTrials.gov NCT00798434.

Keywords: antimuscarinic; lower urinary tract symptoms; micturition; muscarinic antagonists; urinary incontinence.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Benzhydryl Compounds / adverse effects
  • Benzhydryl Compounds / therapeutic use*
  • Double-Blind Method
  • Europe
  • Female
  • Humans
  • Male
  • Muscarinic Antagonists / adverse effects
  • Muscarinic Antagonists / therapeutic use*
  • Prospective Studies
  • Quality of Life
  • Time Factors
  • Treatment Outcome
  • Urinary Bladder / drug effects*
  • Urinary Bladder / physiopathology
  • Urinary Bladder, Overactive / diagnosis
  • Urinary Bladder, Overactive / drug therapy*
  • Urinary Bladder, Overactive / physiopathology
  • Urinary Incontinence / diagnosis
  • Urinary Incontinence / drug therapy*
  • Urinary Incontinence / physiopathology
  • Urination / drug effects

Substances

  • Benzhydryl Compounds
  • Muscarinic Antagonists
  • fesoterodine

Associated data

  • ClinicalTrials.gov/NCT00798434