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Non-surgical Treatments for Urinary Incontinence in Adult Women: Diagnosis and Comparative Effectiveness

Slide: 36 of 50

Continence and Improvement From Pharmacological Interventions for Urgency UI: Placebo Comparisons

Studies reporting benefits of pharmacological interventions reported rates of continence and reports of clinically important improvement in incontinence.

For darifenacin, continence rates were not reported; however, in 3 studies of 1,011 participants, improvement was 1.7 times more likely with darifenacin than with placebo, and the statistically valid range of the effect was from 1.04 to 2.9 times the placebo rate. The number of reports of improvement attributable to darifenacin per 1,000 treated patients was 117, with a statistically valid range of from 57 to 177 reports. The strength of evidence for these findings was high.

For fesoterodine, continence rates were reported in 2 studies of 2,465 participants. The likelihood of continence with fesoterodine was 1.7-fold that of placebo, with a statistically valid range from 0.9- to 3.3-fold as likely. Reports of continence attributable to fesoterodine were determined at a rate of 130 per 1,000 treated patients, with a statistically valid range from 58 to 202 reports per 1,000. The strength of evidence for these findings was low. The likelihood of improvement with fesoterodine treatment was 1.3-fold more likely than with placebo, with a statistically valid range from 1.2- to 1.5-fold as likely. The number of reports of improvement attributable to fesoterodine per 1,000 treated patients was 100, with a statistically valid range of from 56 to 145 reports. The strength of evidence for these findings was moderate.

For oxybutynin, continence rates were reported in 4 studies of 992 participants. Continence was 2.1 times as likely with oxybutynin than with placebo, with a statistically valid range from 1.2 to 3.9. The number of reports attributable to oxybutynin treatment was 114 per 1,000 treated patients, with a statistically valid range of from 64 to 163 reports. The strength of evidence for these findings was high.

In 9 studies of 1,244 participants, improvement was 2.5 times more likely with oxybutynin than with placebo, and the statistically valid range of the effect was from 1.7 to 3.7 times the placebo rate. The number of reports of improvement attributable to oxybutynin was 167 per 1,000 treated patients, with a statistically valid range of from 95 to 240 reports. The strength of evidence for these findings was high.

For solifenacin, continence rates were reported in 5 studies of 6,304 participants. Continence was 1.7 times as likely with oxybutynin than with placebo, with a statistically valid range from 1.3 to 2.1. The number of reports attributable to solifenacin treatment was 107 per 1,000 treated patients, with a statistically valid range of from 58 to 156 reports. The strength of evidence for these findings was high.

In 2 studies of 1,507 participants, improvement was 2.2 times more likely with oxybutynin than with placebo, and the statistically valid range of the effect was from 1.1 to 4.3 times the placebo rate. The number of reports of improvement attributable to solifenacin per 1,000 treated patients was 180, with a statistically valid range of from 97 to 263 reports. The strength of evidence for these findings was low.

For tolterodine, continence rates were reported in 4 studies of 3,404 participants. Continence was 1.5 times as likely with oxybutynin than with placebo, with a statistically valid range from 1.0 to 2.1. The number of reports attributable to solifenacin treatment was 85 per 1,000 treated patients, with a statistically valid range of from 40 to 129 reports per 1,000. The strength of evidence for these findings was high.

In 7 studies of 6,119 participants, improvement was 1.5 times more likely with tolterodine than with placebo, and the statistically valid range of the effect was from 1.2 to 2.0 times the placebo rate. The number of reports of improvement attributable to tolterodine was 96 per 1,000 treated patients, with a statistically valid range of from 42 to 149 reports. The strength of evidence for these findings was high.

For trospium, continence rates were reported in 4 studies of 2,677 participants. Continence was 2.0 times as likely with oxybutynin than with placebo, with a statistically valid range from 1.4 to 2.9. The number of reports attributable to trospium treatment was 114 per 1,000 treated patients, with a statistically valid range of from 83 to 144 reports. The strength of evidence for these findings was high.

In 2 studies of 1,176 participants, no statistically significant difference in improvement was found in comparisons of trospium and placebo. The strength of evidence for this finding is low.