Once-daily Tolterodine treats overactive bladder: More effective than twice-daily version.

CHICAGO -- Once-daily tolterodine 4 mg is an effective, well tolerated, and convenient therapy for overactive bladder in women, two investigators said in separate presentations at the annual meeting of the American Urogynecologic Society.

The efficacy and safety of twice-daily tolterodine 2 mg (Detrol) in the treatment of overactive bladder (OAB) is well established. Recently, a 4-mg extended-release (ER) formulation has become available.

The first study showed that efficacy, safety, and tolerability of the ER formulation are maintained over at least 1 year of treatment, while the second study suggested that tolterodine ER 4 mg is more effective and better tolerated than the old immediate-release (IR) 2-mg formulation. Both studies were funded by the Pharmacia Corp., manufacturer of Detrol.

In the first study, Dr. Alan Garely of North Shore-Long Island Jewish Health System, Great Neck, N.Y., reported on 886 women with OAB who chose to continue treatment with tolterodine ER 4 mg after completing a 12-week, double-blind, randomized trial in which that formulation was compared with tolterodine IR 2 mg.

A total of 634 patients completed 12 months of open-label treatment with tolterodine ER 4 mg.

Primary reasons for withdrawal were adverse events (10%) and lack of efficacy (10%).

Efficacy was maintained during 12 months of treatment, and there was no evidence of tolerance. At 12 months, the number of micturition episodes per day was reduced by 21%. The number of urge incontinence episodes per week was 81% lower, compared with baseline, while the volume voided per micturition was 33% greater.