Introduction. Overactive bladder (OAB) is a symptom complex accompanied by urgency, nicturia with or without urinary incontinence and frequent urina- tion, in the absence of a proven infection or other obvious pathology of the lower urinary tract. The first line of OAB therapy, currently believing, is pharma- cotherapy with muscarinic receptor antagonists. One of them is fesoterodine. The aim of our study was to examine the efficacy of fesoterodine in the treatment of women with overactive bladder syndrome.
Materials and methods. The study included 60 women with symptoms of OAB. Age from 20 to 45 years. All women were given the drug fesoterodine (Toviaz®, Pfizer) at a dosage of 4 mg 1 time per day, which they took for 8 weeks. After 8 weeks (day 60), the efficacy and safety of treatment was assessed. According to the results of an 8-week course of therapy, the patients were divided into two groups. Group 1 included women in whom the therapy was effective (reduction in the number of infections, absence of nocturia and urgent urges). This group continued treatment with fesoterodine at doses of 4 mg 1 time per day. Group 2 included patients who had low efficiency of treatment (preserved pollakiuria, nocturia and urgent urges). They were asked to increase the dose to 8mg per day. After 8 weeks (day 120), a comparative evaluation of the effectiveness and safety of the therapy in the two groups was made.
Results and discussion. Upon treatment, all women were diagnosed with symptoms characteristic of the manifestations of OAB. Receiving fesoterodine for 8 weeks at a dosage of 4 mg 1 time per day allowed to reduce the total number of micci, as well as urgent and nighttime urge to urinate according to the diaries of urination. There was also an improvement in the quality of life on the Sf-36 scale. Adverse events were reported in 2 (3.33%) patients and manifested in the form of dry mouth. According to the results of the 8-week course of therapy, the analysis of cases of low efficiency of treatment (patients who retained pollakiuria, nocturia and urgent urges) was made, on the basis of which the women were divided into two groups for the second stage of the study. At the end of the second stage in the group of patients who switched to a higher dosage of the drug, there was a significant positive dynamic (p < 0.05). In group 1, comparable results close to normal values were obtained. There were no significant differences in the studied parameters between the groups (p > 0.05). There were 2 cases of adverse events (dry mouth and constipation), so their number increased to 4 and amounted to 6.7% of the total number of patients.
Conclusion. Thus, the drug Toviaz® (fesoterodine) has a high safety profile and effectively relieves lower urinary tract symptoms in women with overactive bladder syndrome and also improves the quality of their lives. The data obtained justify the feasibility of two different doses of fesoterodine in clinical practice: the recommended initial dose is 4 mg for all patients, with a possible increase in the dose of fesoterodine to 8 mg in patients who required high dose for optimal relief of symptoms.
Conflict of interest. The authors declare no conflict of interest.