title: Dose and aging effect on patients reported treatment benefit switching from the first overactive bladder therapy with tolterodine ER to fesoterodine: post-hoc analysis from an observational and retrospective study.
abstract: BACKGROUND
  Previous randomized studies have demonstrated that fesoterodine significantly improves the Overactive Bladder (OAB) symptoms and their assessment by patients compared with tolterodine extended-release (ER). This study aimed to assess the effect of aging and dose escalation on patient-reported treatment benefit, after changing their first Overactive Bladder (OAB) therapy with tolterodine-ER to fesoterodine in daily clinical practice.
  
  
  METHODS
  A post-hoc analysis of data from a retrospective, cross-sectional and observational study was performed in a cohort of 748 OAB adults patients (OAB-V8 score ≥8), who switched to fesoterodine from their first tolterodine-ER-based therapy within the 3-4 months before study visit. Effect of fesoterodine doses (4 mg vs. 8 mg) and patient age (<65 yr vs. ≥65 yr) were assessed. Patient reported treatment benefit [Treatment Benefit Scale (TBS)] and physician assessment of improvement with change [Clinical Global Impression of Improvement subscale (CGI-I)] were recorded. Treatment satisfaction, degree of worry, bother and interference with daily living activities due to urinary symptoms were also assessed.
  
  
  RESULTS
  Improvements were not affected by age. Fesoterodine 8 mg vs. 4 mg provides significant improvements in terms of treatment benefit [TBS 97.1% vs. 88.4%, p < 0.001; CGI-I 95.8% vs. 90.8% p < 0.05)], degree of worry, bother and interference with daily-living activities related to OAB symptoms (p <0.05).
  
  
  CONCLUSIONS
  A change from tolterodine ER therapy to fesoterodine with dose escalation to 8 mg in symptomatic OAB patients, seems to be associated with greater improvement in terms of both patient-reported-treatment benefit and clinical global impression of change. Improvement was not affected by age.
authors: Department of Urology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain. davidcastro@teide.net
authors: David
authors: D
authors: Castro-Diaz
authors: Pilar
authors: P
authors: Miranda
authors: Francisco
authors: F
authors: Sanchez-Ballester
authors: Isabel
authors: I
authors: Lizarraga
authors: Daniel
authors: D
authors: Arumí
authors: Javier
authors: J
authors: Rejas
mesh_terms: D000368:Aged; D000375:Aging / Q000187:drug effects* / Q000473:pathology / Q000523:psychology; D001559:Benzhydryl Compounds / Q000008:administration & dosage*; D015331:Cohort Studies; D003408:Cresols / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D003692:Delayed-Action Preparations / Q000008:administration & dosage; D057915:Drug Substitution / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010665:Phenylpropanolamine / Q000008:administration & dosage*; D012189:Retrospective Studies; D000068737:Tolterodine Tartrate; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000188:drug therapy* / Q000473:pathology / Q000523:psychology
chemical_list: D001559:Benzhydryl Compounds; D003408:Cresols; D003692:Delayed-Action Preparations; D010665:Phenylpropanolamine; D000068737:Tolterodine Tartrate; C526675:fesoterodine