Oxybutynin extended release for the management of overactive bladder: a clinical review

A double-blind, randomized, placebo-controlled study to evaluate the efficacy of Oxybutynin Chloride Extended-Release tablets on the double-J stent related symptoms following uncomplicated ureteroscopic lithotripsy

To evaluate the effects of Oxybutynin Chloride Extended-Release Tablets (Oxbu) on double-J stent-related symptoms following uncomplicated ureterosocpic lithotripsy (URSL). This is a double-blind, randomized, placebo-controlled study with a total of 120 subjects with ureteral calculi receiving double-J stent insertion following URSL. Subjects who meet the inclusion and exclusion criteria will be randomly assigned to Oxbu or placebo group. All patients completed a structured questionnaire assessing the stent-related symptoms one week after operation. The clinical data and stent characteristics were recorded as well. The severity of stent-related symptoms was compared between two groups. The mean age were 58.2 years both in Oxbu group and control group, and the demographic data were all comparable between the two groups. Oxbu group had significant improvement for stent related pain score (-0.47 points, P < 0.01) and quality of life score (-0.17 points, P < 0.01) compared to the control group. The male subgroup showed that Oxbu had less urgency item score (-0.59 points, P < 0.05). The subgroup analysis for female showed that Oxbu had more decrease in the intermittency item score (-0.89 points, P = 0.043) and aged < 50 showed Oxbu had more decrease in Overactive Bladder Symptoms Score total score and urgency item score (-0.8 and - 0.6 points, all P < 0.05). This study showed that Oxbu decreases the severity of double-J stent related pain and the quality of life score for patients received URSL. In the IPSS and OABSS item, the intermittency and urgency are improved in the Oxbu group. In conclusion, Oxbu treatment had beneficial effects to improve the severity of stent related symptoms.

Long-term results of oxybutynin treatment for palmar hyperhidrosis

PURPOSE

Palmar hyperhidrosis (PH) is a common illness that significantly impacts Quality of Life (QOL). Oxybutynin offers excellent short-term results, but long-term follow-up results are limited. We evaluated its effectiveness in a large group of patients who did not have surgery and who had at least 6 months of follow-up.

METHODS

Between September 2007 and September 2013, 570 consecutive patients were enrolled in our institutional protocol regarding the "pharmacological-first" treatment of primary PH with oxybutynin. Fifty-nine were lost to follow-up, and the data were available for 511 patients treated for at least 6 weeks. Data recorded at the start of the protocol, 6 weeks after beginning treatment, and during patients' final visits were analyzed.

RESULTS

112 patients (21.9 %) did not improve and were referred for surgery (sympathectomy). Eight (1.56 %) developed significant side effects (e.g., dry mouth) and discontinued therapy. Thirty (5.9 %) preferred surgery over pharmacological treatment. 111 have not yet received treatment for 6 months. The 246 patients with more than 6 months of follow-up (median 16 months, range 6-72) were analyzed, as follows: 90.2 % experienced moderate or great improvement in their PH; 90.34 % experienced improvement at other sites of hyperhidrosis following a median of 16 months.

CONCLUSION

Among patients with good initial responses to oxybutynin, more than 90 % experienced moderate or great improvement in their palmar sweating, as well as in their hyperhidrosis in other sites, after 6 months. The results were particularly favorable in those patients with BMI <25 kg/m(2), and in those who noted an improved QOL after 6 weeks.

Analysis of oxybutynin treatment for hyperhidrosis in patients aged over 40 years

Objective:

Our aim was to analyze the effectiveness of oxybutynin for hyperhidrosis treatment in patients over 40 years.

Methods:

Eighty-seven patients aged over 40 years were divided into two groups. One group consisted of 48 (55.2%) patients aged between 40 and 49 years, and another was composed of 39 (44.8%) patients aged over 50 years (50 to 74 years). A comparative analysis of Quality of Life and level of hyperhidrosis between the groups was carried out 6 weeks after a protocol treatment with oxybutynin. A validated clinical questionnaire was used for evaluation.

Results:

In the younger age group, 75% of patients referred a “partial” or “great” improvement in level of hyperhidrosis after treatment. This number was particularly impressive in patients over 50 years, in which 87.2% of the cases demonstrated similar levels of improvement. Over 77% of patients in both groups demonstrated improvement in Quality of Life. Excellent outcomes were observed in older patients, in which 87.1% of patients presented “slightly better” (41%) or “much better” (46.1%) improvement.

Conclusion:

Patients aged over 40 years with hyperhidrosis presented excellent results after oxybutynin treatment. These outcomes were particularly impressive in the age group over 50 years, in which most patients had significant improvement in Quality of Life and in level of hyperhidrosis.

The effect of oxybutynin on cardiac autonomic modulation in healthy subjects

PURPOSE

The aim of this study was to assess the various doses of oral oxybutynin on cardiac autonomic modulation by measuring short-term heart rate variability (HRV) indexes during supine rest position.

METHODS

Eight male healthy subjects (20-23 years) participated in the double-blind crossover randomized study. The single dose of oxybutynin (2.5, 5 and 10 mg) or placebo was given to the volunteers in four sessions within 5-day intervals. Before and minutes of 30, 60, 90 and 120 after administration, lead II electrocardiogram (ECG) was recorded for 5 min. ECG extracted RR intervals data became the base of the calculation of time domain and frequency domain HRV parameters, which indicate cardiac autonomic activity. Statistical analysis was done by using the nonparametric Wilcoxon and Kruskal-Wallis tests.

RESULTS

The data analysis has revealed that MNN (P < 0.001), SDNN (P < 0.05), PNN50% (P < 0.01), RMSSD (P < 0.001), HFnu (P < 0.05) and LF/HF ratio (P < 0.05) values were significantly increased relative to baseline at various time points in all the groups except in placebo group. LFnu (P < 0.05) values were significantly increased relative to baseline at various time points in all the groups except in placebo group.

CONCLUSIONS

Our findings have revealed that acute consumption of 2.5, 5 and 10 mg oxybutynin (an anticholinergic compound) in the juvenile healthy male subjects produces a cholinergic effect according to time and frequency domain of HRV indexes.