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Efficacy, tolerability, and safety of oxybutynin chloride in pediatric neurogenic bladder with spinal dysraphism: a retrospective, multicenter, observational study.

Lee JH, Kim KR, Lee YS, Han SW, Kim KS, Song SH, Baek M, Park K - Korean J Urol (2014)

Bottom Line: Likewise, mean EFP was reduced from 33 to 21 cm H2O.OC is safe and efficacious in treating pediatric neurogenic bladder associated with SD.The drug is also tolerable and the safety profile suggests that adjustment of dosage for age may not be strictly observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: Anticholinergics are a key element in treating neurogenic detrusor overactivity, but only limited data are available in the pediatric population, thus limiting the application to children even for oxybutynin chloride (OC), a prototype drug. This retrospective study was designed to provide data regarding the efficacy, tolerability, and safety of OC in the pediatric population (0-15 years old) with spinal dysraphism (SD).

Materials and methods: Records relevant to OC use for neurogenic bladder were gathered and scrutinized from four specialized clinics for pediatric urology. The primary efficacy outcomes were maximal cystometric capacity (MCC) and end filling pressure (EFP). Data on tolerability, compliance, and adverse events (AEs) were also analyzed.

Results: Of the 121 patient records analyzed, 41 patients (34%) received OC at less than 5 years of age. The range of prescribed doses varied from 3 to 24 mg/d. The median treatment duration was 19 months (range, 0.3-111 months). Significant improvement of both primary efficacy outcomes was noted following OC treatment. MCC increased about 8% even after adjustment for age-related increases in MCC. Likewise, mean EFP was reduced from 33 to 21 cm H2O. More than 80% of patients showed compliance above 70%, and approximately 50% of patients used OC for more than 1 year. No serious AEs were reported; constipation and facial flushing consisted of the major AEs.

Conclusions: OC is safe and efficacious in treating pediatric neurogenic bladder associated with SD. The drug is also tolerable and the safety profile suggests that adjustment of dosage for age may not be strictly observed.

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Related in: MedlinePlus

Comparison of maximal cystometric capacity (A), age adjusted maximal cystometric capacity (B), and end filling pressure (C) between pretreatment and posttreatment with oxybutynin chloride. Each value represents mean±standard deviation. *p<0.05. **p<0.01.
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Figure 1: Comparison of maximal cystometric capacity (A), age adjusted maximal cystometric capacity (B), and end filling pressure (C) between pretreatment and posttreatment with oxybutynin chloride. Each value represents mean±standard deviation. *p<0.05. **p<0.01.

Mentions: The primary urodynamic parameters, MCC and EFP, were improved significantly following OC treatment (Fig. 1). This improvement in MCC was maintained even after we adjusted for age-related increases in bladder capacity. The mean percentages of the expected age-adjusted capacities were still significantly increased by 8% (Wilcoxon singed rank test) even after this adjustment. Compared to pretreatment values, 65 (53%) and 31 (26%) achieved improvement and normalization of adjusted bladder capacity, respectively, following OC treatment.


Efficacy, tolerability, and safety of oxybutynin chloride in pediatric neurogenic bladder with spinal dysraphism: a retrospective, multicenter, observational study.

Lee JH, Kim KR, Lee YS, Han SW, Kim KS, Song SH, Baek M, Park K - Korean J Urol (2014)

Comparison of maximal cystometric capacity (A), age adjusted maximal cystometric capacity (B), and end filling pressure (C) between pretreatment and posttreatment with oxybutynin chloride. Each value represents mean±standard deviation. *p<0.05. **p<0.01.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4265718&req=5

Figure 1: Comparison of maximal cystometric capacity (A), age adjusted maximal cystometric capacity (B), and end filling pressure (C) between pretreatment and posttreatment with oxybutynin chloride. Each value represents mean±standard deviation. *p<0.05. **p<0.01.
Mentions: The primary urodynamic parameters, MCC and EFP, were improved significantly following OC treatment (Fig. 1). This improvement in MCC was maintained even after we adjusted for age-related increases in bladder capacity. The mean percentages of the expected age-adjusted capacities were still significantly increased by 8% (Wilcoxon singed rank test) even after this adjustment. Compared to pretreatment values, 65 (53%) and 31 (26%) achieved improvement and normalization of adjusted bladder capacity, respectively, following OC treatment.

Bottom Line: Likewise, mean EFP was reduced from 33 to 21 cm H2O.OC is safe and efficacious in treating pediatric neurogenic bladder associated with SD.The drug is also tolerable and the safety profile suggests that adjustment of dosage for age may not be strictly observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: Anticholinergics are a key element in treating neurogenic detrusor overactivity, but only limited data are available in the pediatric population, thus limiting the application to children even for oxybutynin chloride (OC), a prototype drug. This retrospective study was designed to provide data regarding the efficacy, tolerability, and safety of OC in the pediatric population (0-15 years old) with spinal dysraphism (SD).

Materials and methods: Records relevant to OC use for neurogenic bladder were gathered and scrutinized from four specialized clinics for pediatric urology. The primary efficacy outcomes were maximal cystometric capacity (MCC) and end filling pressure (EFP). Data on tolerability, compliance, and adverse events (AEs) were also analyzed.

Results: Of the 121 patient records analyzed, 41 patients (34%) received OC at less than 5 years of age. The range of prescribed doses varied from 3 to 24 mg/d. The median treatment duration was 19 months (range, 0.3-111 months). Significant improvement of both primary efficacy outcomes was noted following OC treatment. MCC increased about 8% even after adjustment for age-related increases in MCC. Likewise, mean EFP was reduced from 33 to 21 cm H2O. More than 80% of patients showed compliance above 70%, and approximately 50% of patients used OC for more than 1 year. No serious AEs were reported; constipation and facial flushing consisted of the major AEs.

Conclusions: OC is safe and efficacious in treating pediatric neurogenic bladder associated with SD. The drug is also tolerable and the safety profile suggests that adjustment of dosage for age may not be strictly observed.

Show MeSH
Related in: MedlinePlus