Efficacy of Solifenacin and trospium chloride on neurogenic bladder after stroke: a multicentric three arms placebo-controlled trial

Abstract

Urinary symptoms in neurogenic bladder after stroke are seen in a large percentage of patients. Despite the various type of treatment lines in management of symptoms in overactive bladder non-pharmacologically, pharmacologically and surgically, antimuscarinic-based drug therapy, especially newer drugs, are considered a standard treatment method in the early and advanced stages of the disease. But choosing the preferred drug with less complications is still challenging for physicians. Therefore, as there hasn’t been done head to head clinical trial among these drugs, we did this study, to compare trospium chloride and solifenacin as new generation in this category of drugs. Methods: For this purpose, 201 patients were included in a clinical trial study in three arms of solifinacin, trospium chloride and placebo. Of these, 63 patients were included in the control group, 69 patients in the solifenacin group, and 74 patients in the trospium chloride group in a random and triple-blind manner. Patients were compared in terms of symptom severity using NBSS, ICIQ and QOL-SF questionnaires at the beginning and 4 weeks after the intervention. Findings: According to the results of data analysis with the results of ANOVA test and chi-square test, it was shown that the severity of symptoms decreased in all three groups after treatment, but this reduction in the amount of symptoms in the solifenacin and trospium chloride drug groups was significantly more than the placebo group. Also, there was no significant difference between the two drugs. in terms of side effects, in the trospium chloride group, 36% of people reported side effects caused by anticholinergic drugs, including constipation, dry mouth, and dizziness. While these side effects were reported only in 10% of people receiving solifenacin.