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    Overactive bladder: Two drugs found better than one


    Combination therapy reduced the mean daily number of incontinence episodes by 1.80 compared with 1.53 episodes for monotherapy with 5 mg of solifenacin, a statistically significant difference (p=.001). The mean number of daily micturitions in the combination group decreased by 1.53 compared with 1.14 in the solifenacin, 5 mg group, also statistically significant (p<.001).

    Combination therapy was noninferior to solifenacin, 10 mg daily for both mean number of micturitions per 24 hours and number of incontinence episodes during the 3-day diary. It was superior to 10-mg monotherapy for decrease in micturitions per 24 hours and superior to both 5-mg and 10-mg monotherapy for increase in urine volume voided per micturition.

    Patients tolerated all three treatments well, with no new adverse events reported beyond the known profiles for solifenacin and mirabegron. The most common adverse events, reported by at least 2% of patients, were dry mouth, constipation, and peripheral edema.

    “The findings hold out hope for people with severe urinary symptoms of urgency or urgency incontinence,” said lead investigator Marcus Drake, MA, DM, of the University of Bristol and Bristol Urological Institute, Bristol, UK. “We can now anticipate future availability of effective and well-tolerated therapy, and reduce the need for invasive surgical treatments.”

    The BESIDE trial was funded by Astellas Pharma Inc., the manufacturer of mirabegron and solifenacin.

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