Long-term safety and efficacy of trospium chloride for the treatment of neurogenic overactive bladder due to Parkinson's disease - is there an effect on cognitive status?

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Abstract

Aim. To evaluate the efficiency of long-term use of trospium chloride (Spazmex) for the treatment of patients with neurogenic overactive bladder due to Parkinson's disease (PD) and to determine the influence of therapy on the cognitive status of patients. Materials and methods: 60 patients with PD and neurogenic overactive bladder with stages 2.5, 3 and 4 according to Hoehn-Yahr scale were included in the main group. The mean age was 58.2±5.7 years. All patients were prescribed trospium chloride at entry into the study, with doses titrated gradually according to clinical efficacy (30 to 90 mg). The comparison group included 15 patients with PD and neurogenic overactive bladder at stages 2,5 and 3, who received tibial neuromodulation according to the standard technique with skin electrodes. The mean age of patients was 56.4±4.6 years. At baseline, both groups were comparable in terms ofgender, age and cognitive status (p=0.801). All patients received treatment for 52 weeks. The efficiency of therapy was assessed according to bladder diaries, while safety outcomes included postvoid residual, side effects, cognitive status according to the MoCA scale and quality of life according to the SF-Qualiveen questionnaire. Results: clinical efficacy and satisfaction were achieved in all patients who completed the study (47 patients in the main group and 15 patients in the comparison group). Good clinical efficacy was demonstrated in both groups, since there was a decrease in the number of urinations, episodes of urgency and urinary incontinence. In addition, there was an improvement in the quality of life according to the SF-Qualiveen scale. The cognitive status during the entire follow-up period remained without significant changes in both groups. Conclusion. Trospium chloride is an effective drug in patients with PD. It does not affect cognitive functions during long-term use. Trospium chloride should be considered as first-line drug in those with urologic manifestations of PD.

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About the authors

E. S Korshunova

FGBNU Research Center of Neurology; FGBU “Central state medical academy” of Administrative Directorate of the President of Russian Federation; A.I. Evdokimov’s Moscow State University of Medicine and Dentistry

Email: e_korshunova@mail.ru
Ph.D., associate professor Moscow, Russia; Moscow, Russia

M. N Andreev

FGBNU Research Center of Neurology; M.V. Lomonosov’s Moscow State University

neurologist; Ph.D. student of the Faculty of Fundamental Medicine Moscow, Russia

M. N Korshunov

FGBU “Central state medical academy” of Administrative Directorate of the President of Russian Federation

PhD, associate professor Moscow, Russia

T. M Pyatnitskaya

M.V. Lomonosov’s Moscow State University

Email: tomapyatnitskaya@gmail.com
student Moscow, Russia

D. M Korshunov

A.I. Evdokimov’s Moscow State University of Medicine and Dentistry

student Moscow, Russia

S. P Darenkov

FGBU “Central state medical academy” of Administrative Directorate of the President of Russian Federation

Ph.D., MD, Professor, Head of the Department of Urology Moscow, Russia

N. A Suponeva

FGBNU Research Center of Neurology

Ph.D., MD, Professor, Corresponding member of Russian Academy of Sciences, Director of the Institute of Neurorehabilitation Moscow, Russia

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