Anticholinergic drugs versus other medications for overactive bladder syndrome in adults

Campbell Roxburgh; Jonathan Cook; Norman Dublin

doi:10.1002/14651858.CD003190.pub4

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Analysis 2.2

Comparison 2 Anticholinergics versus afferent nerve inhibitors, Outcome 2 Number not cured after treatment.

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Analysis 2.4

Comparison 2 Anticholinergics versus afferent nerve inhibitors, Outcome 4 Number not improved after treatment.

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Analysis 2.10

Comparison 2 Anticholinergics versus afferent nerve inhibitors, Outcome 10 Improvement in urodynamic diagosed detrusor overactivity.

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Analysis 2.12

Comparison 2 Anticholinergics versus afferent nerve inhibitors, Outcome 12 Number of micturitions per 24hours.

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Analysis 5.2

Comparison 5 Anticholinergics versus Flavoxate, Outcome 2 Number not cured after treatment.

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Analysis 5.4

Comparison 5 Anticholinergics versus Flavoxate, Outcome 4 Number not improved after treatment.

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Analysis 5.6

Comparison 5 Anticholinergics versus Flavoxate, Outcome 6 Number with nocturia after treatment.

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Analysis 5.14

Comparison 5 Anticholinergics versus Flavoxate, Outcome 14 Number experiencing adverse effects.

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Analysis 5.15

Comparison 5 Anticholinergics versus Flavoxate, Outcome 15 Number withdrawing from treatment.

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Analysis 6.14

Comparison 6 Anticholinergics versus other medications, Outcome 14 Number experiencing adverse effects.

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Comparison 1. Anticholinergics versus tricyclics or monoamine inhibitors

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number not cured during treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Number not cured after treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Number not improved during treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 Number not improved after treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Number with nocturia during treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 Number with nocturia after treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7 Number of pad changes over 24hrs	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
8 Number not cured on Urodynamics	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9 Number of incontinent episodes over 24hrs	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
10 Number with no Improvement in urodynamic diagnosed detrusor overactivity	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
11 Mean volume or weight of urine loss on pad test	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12 Number of micturitions per 24hours	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
13 Frequency of sensation of urgency	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
14 Number experiencing adverse effects	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
15 Number withdrawing from treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
16 Number changing dose of treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 1. Anticholinergics versus tricyclics or monoamine inhibitors

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Comparison 2. Anticholinergics versus afferent nerve inhibitors

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number not cured during treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Number not cured after treatment Show forest plot	1	30	Risk Ratio (M‐H, Fixed, 95% CI)	1.5 [0.71, 3.16]

3 Number not improved during treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 Number not improved after treatment Show forest plot	1	30	Risk Ratio (M‐H, Fixed, 95% CI)	1.5 [0.53, 4.26]

5 Number with nocturia during treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 Number with nocturia after treament	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7 Number of pad changes over 24hrs	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
8 Number not cured on urodynamics	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9 Number of incontinent episodes over 24hrs	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
10 Improvement in urodynamic diagosed detrusor overactivity Show forest plot	1	30	Risk Ratio (M‐H, Fixed, 95% CI)	0.64 [0.34, 1.18]

11 Mean volume or weight of urine loss on pad test	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12 Number of micturitions per 24hours Show forest plot	1	30	Mean Difference (IV, Fixed, 95% CI)	3.0 [1.91, 4.09]

13 Frequency of sensation of urgency	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
14 Number experiencing adverse effects	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
15 Number withdrawing from treament	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
16 Number changing dose of treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 2. Anticholinergics versus afferent nerve inhibitors

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Comparison 3. Anticholinergics versus Botulinum Toxin

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number not cured during treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Number not cured after treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Number not improved during treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 Number not improved after treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Number with nocturia during treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 Number with nocturia after treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7 Number of pad changes per 24hrs	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
8 Number not cured on urodynamics	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9 Number of incontinent episodes per 24hrs	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
10 Improvement in urodynamic diagnosed overactivity	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
11 Mean volume or weight urine loss on pad test	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12 Number of micturitions per 24hrs	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
13 Frequency of sensation of urgency	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
14 Number experiencing adverse effects	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
15 Number withdrawing from treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
16 Number changing dose of treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 3. Anticholinergics versus Botulinum Toxin

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Comparison 4. Anticholinergics versus alpha adrenergic adonists

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number not cured during treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Number not cured after treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Number not improved during treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 Number not improved after treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Number with nocturia during treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 Number with nocturia after treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7 Number of pad changes per 24hrs	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
8 Number not cured on urodynamics	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9 Number of incontinent episodes per 24hrs	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
10 Improvement in urodynamic diagnosed overactivity	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
11 Mean volume or weight urine loss on pad test	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12 Number of micturations per 24hrs	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
13 Frequency of sensation of urgency	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
14 Number experiencing adverse effects	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
15 Number withdrawing from treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
16 Number changing dose or treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 4. Anticholinergics versus alpha adrenergic adonists

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Comparison 5. Anticholinergics versus Flavoxate

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number not cured during treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Number not cured after treatment Show forest plot	2	240	Risk Ratio (M‐H, Fixed, 95% CI)	0.97 [0.90, 1.05]

3 Number not improved during treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 Number not improved after treatment Show forest plot	2	240	Risk Ratio (M‐H, Random, 95% CI)	1.01 [0.46, 2.22]

5 Number with nocturia during treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 Number with nocturia after treatment Show forest plot	1	45	Risk Ratio (M‐H, Fixed, 95% CI)	0.96 [0.66, 1.39]

7 Number of pad changes over 24 hours	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
8 Number not cured on urodynamics	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9 Number of incontinent episodes per 24 hours	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
10 Number with no improvement in urodynamic diagnosed detrusor overactivity	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
11 Mean volume or weight urine loss on pad test	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12 Number of micturitions per 24 hours	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
13 Frequency of sensation of urgency	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
14 Number experiencing adverse effects Show forest plot	3	283	Risk Ratio (M‐H, Fixed, 95% CI)	2.28 [1.45, 3.56]

15 Number withdrawing from treatment Show forest plot	2	270	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.49, 1.77]

16 Number changing dose of treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 5. Anticholinergics versus Flavoxate

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Comparison 6. Anticholinergics versus other medications

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number not cured during treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Number not cured after treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Number not improved during treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 Number not improved after treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Number with nocturia during treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 Number with nocturia after treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7 Number of pad changes over 24 hours	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
8 Number not cured on urodynamics	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9 Number of incontinent episodes per 24 hours	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
10 Number with no improvement in urodynamic diagnosed detrusor overactivity	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
11 Mean volume or weight urine loss on pad test	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12 Number of micturitions per 24 hours	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
13 Frequency of sensation of urgency	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
14 Number experiencing adverse effects Show forest plot	1	42	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

15 Number withdrawing from treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
16 Number changing dose of treatment	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 6. Anticholinergics versus other medications

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