The concomitant use of fesoterodine and topical vaginal estrogen in the management of overactive bladder and sexual dysfunction in postmenopausal women. (March 2016)

• Record Type: Journal Article
• Authors: Chughtai, Bilal; Forde, James C; Buck, Jessica; Asfaw, Tirsit; Lee, Richard; Te, Alexis E; Kaplan, Steven A
• Is Part Of: Post reproductive health. Volume 22:Number 1(2016:Mar.)
• Page Start: 34
• Page End: 40
• Publication Date: 2016-03
• Subjects: Overactive bladder -- female sexual dysfunction -- postmenopausal -- topical vaginal estrogen -- fesoterodine; Menopause -- Periodicals; Older women -- Diseases -- Periodicals; 612.665
• DOI: 10.1177/2053369116633017
• Languages: English
• ISSNs: 2053-3691

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.