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      Fesoterodine for the treatment of urinary incontinence and overactive bladder

      Therapeutics and Clinical Risk Management

      Dove Medical Press

      overactive bladder, antimuscarinic agent, esterase, 5-HMT, fesoterodine

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          Abstract

          Overactive bladder (OAB) is a highly prevalent condition, affecting males and females. The prevalence increases with age. Behavioral therapy and antimuscarinic therapy remain the first-line therapies for management of OAB. Despite improvements in symptoms, persistence with antimuscarinic therapy has remained low. Multiple factors including patient expectations, adverse effects and cost may affect persistence. Fesoterodine is one of the newest antimuscarinic agent approved for the management of OAB. It is unique in that it shares the same active metabolite as tolterodine, 5-hydoxymethyltolterodine (5-HMT); however, this conversion is established via ubiquitous esterases and not via the cytochrome P450 system, thus providing a faster and more efficient conversion to 5-HMT. Fesoterodine is available in 2 doses, 4 mg and 8 mg. Clinical trials have established a dose response relationship in efficacy parameters as well as improvements in quality of life. As with all antimuscarinics, dry mouth and constipation are the more common side effects. A combination of medical therapy and behavioral therapy improves the overall outcome in management of OAB. Dose flexibility may help improve efficacy outcomes and patient education on the management of common adverse effects may improve tolerability with these agents.

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          Author and article information

          Journal
          Ther Clin Risk Manag
          Therapeutics and Clinical Risk Management
          Therapeutics and Clinical Risk Management
          Dove Medical Press
          1176-6336
          1178-203X
          2009
          2009
          18 November 2009
          : 5
          : 869-876
          Affiliations
          The Alpert School of Medicine at Brown University Providence, RI, USA
          Author notes
          Correspondence: Pamela Ellsworth, University Urological Associates, Inc, 2 Dudley St., Suite 185, Providence, RI 02905, USA, Email pamelaellsworth@ 123456aol.com
          Article
          tcrm-5-869
          2781061
          19956551
          © 2009 Ellsworth, publisher and licensee Dove Medical Press Ltd.

          This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

          Categories
          Review

          Medicine

          fesoterodine, 5-hmt, overactive bladder, antimuscarinic agent, esterase

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