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Solifenacin for the treatment of overactive bladder

Dudley Robinson and Linda Cardozo

Overactive bladder, defined as a symptom complex of urinary urgency, usually accompanied by frequency and nocturia, with or without urgency urinary incontinence, in the absence of urinary tract infection or other obvious pathology, is a bothersome condition known to affect quality of life. Whilst the majority of patients will initially benefit from conservative measures in the first instance, drug therapy remains integral in the management of patients with overactive bladder. The development of the newer bladder selective M3 specific antagonists such as solifenacin has introduced the possibility of increasing efficacy whilst minimizing the antimuscarinic adverse effects of dry mouth, constipation, somulence and blurred vision. Solifenacin, launched in the UK in 2004, has been investigated in a large series of Phase III clinical trials documenting efficacy in treating all symptoms of the overactive bladder syndrome. More recently a Phase IV development program has assessed the use of solifenacin in specific patient groups and also in comparative studies with other antimuscarinic drugs. This manuscript will provide a brief overview of overactive bladder as well as reviewing the efficacy and safety data from the solifenacin clinical development program.