The concomitant use of fesoterodine and topical vaginal estrogen in the management of overactive bladder and sexual dysfunction in postmenopausal women.

Abstract

OBJECTIVE:

The objective of this study is to investigate the combination effect of anti-muscarinic medication and topical vaginal estrogen in the treatment of overactive bladder (OAB) and female sexual dysfunction in postmenopausal women.

STUDY DESIGN:

After IRB approval, 23 female subjects who met the entry criteria were randomized into two groups: (1) fesoterodine (Toviaz®, Pfizer, NY) with topical vaginal estrogen (Premarin®, Pfizer, NY) once daily or (2) fesoterodine once daily alone. If 4 mg fesoterodine was tolerated at 1-week, the dose was increased to 8 mg.

MAIN OUTCOME MEASURES:

Primary endpoints were improvement in OAB symptom severity (Overactive Bladder Questionnaire, OAB-Q SF), improvement in OAB health-related quality of life (HRQL) (OAB-Q SF), and sexual function (Sexual Quality of Life-Female, SQOL-F) after 12 weeks. Secondary endpoint was change in total number of micturitions.

RESULTS:

After 12-weeks, the combination group had a significant improvement in OAB symptom severity (p = 0.006), HRQL (p = 0.029), and SQOL-F (0.0003). The fesoterodine alone group also had significant improvement in OAB symptom severity (p < 0.0001), HRQL (p = 0.0002), and SQOL-F (p = 0.02). When compared directly to the fesoterodine alone group, the combination group after 12-weeks had a reduced OAB symptom severity (10 versus 23.3; p = 0.35), higher HRQL (96.9 versus 84.6; p = 0.75), and higher SQOL-F (99 versus 81; p = 0.098). The total number of micturitions over 3 d was significantly reduced in the combination group (45-26, p = 0.03) between baseline and 12-weeks.

CONCLUSIONS:

The combined effect of fesoterodine and topical vaginal estrogen improved OAB symptoms and sexual function in postmenopausal women.

• Authors: Bilal Chughtai, James C Forde, Jessica Buck, Tirsit Asfaw, Richard Lee, Alexis E Te, Steven A Kaplan
• Journal: Post reproductive health (Post Reprod Health) Vol. 22 Issue 1 Pg. 34-40 (Mar 2016) ISSN: 2053-3705 [Electronic] United States
• PMID: 26883688 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2016.

Chemical References

• Benzhydryl Compounds
• Estrogens
• Muscarinic Antagonists
• fesoterodine

Topics

• Administration, Intravaginal
• Adult
• Aged
• Benzhydryl Compounds (therapeutic use)
• Drug Therapy, Combination
• Estrogens (administration & dosage)
• Female
• Humans
• Middle Aged
• Muscarinic Antagonists (therapeutic use)
• Postmenopause
• Quality of Life
• Severity of Illness Index
• Sexual Dysfunctions, Psychological (drug therapy, etiology)
• Sexuality
• Surveys and Questionnaires
• Urinary Bladder, Overactive (complications, drug therapy)