Efficacy, tolerability, and safety of oxybutynin chloride in pediatric neurogenic bladder with spinal dysraphism: a retrospective, multicenter, observational study.
PURPOSE
Anticholinergics are a key element in treating neurogenic detrusor overactivity, but only limited data are available in the pediatric population, thus limiting the application to children even for oxybutynin chloride (OC), a prototype drug. This retrospective study was designed to provide data regarding the efficacy, tolerability, and safety of OC in the pediatric population (0-15 years old) with spinal dysraphism (SD).


MATERIALS AND METHODS
Records relevant to OC use for neurogenic bladder were gathered and scrutinized from four specialized clinics for pediatric urology. The primary efficacy outcomes were maximal cystometric capacity (MCC) and end filling pressure (EFP). Data on tolerability, compliance, and adverse events (AEs) were also analyzed.


RESULTS
Of the 121 patient records analyzed, 41 patients (34%) received OC at less than 5 years of age. The range of prescribed doses varied from 3 to 24 mg/d. The median treatment duration was 19 months (range, 0.3-111 months). Significant improvement of both primary efficacy outcomes was noted following OC treatment. MCC increased about 8% even after adjustment for age-related increases in MCC. Likewise, mean EFP was reduced from 33 to 21 cm H2O. More than 80% of patients showed compliance above 70%, and approximately 50% of patients used OC for more than 1 year. No serious AEs were reported; constipation and facial flushing consisted of the major AEs.


CONCLUSIONS
OC is safe and efficacious in treating pediatric neurogenic bladder associated with SD. The drug is also tolerable and the safety profile suggests that adjustment of dosage for age may not be strictly observed.
['Lee|Jung Hoon|JH|', 'Kim|Kyoung Rok|KR|', 'Lee|Yong Seung|YS|', 'Han|Sang Won|SW|', 'Kim|Kun Suk|KS|', 'Song|Sang Hoon|SH|', 'Baek|Minki|M|', 'Park|Kwanjin|K|']
D000293:Adolescent D002648:Child D002675:Child, Preschool D004341:Drug Evaluation D005260:Female D006801:Humans D007223:Infant D007231:Infant, Newborn D008297:Male D008333:Mandelic Acids D018727:Muscarinic Antagonists D012189:Retrospective Studies D016135:Spinal Dysraphism D016896:Treatment Outcome D001750:Urinary Bladder, Neurogenic D064804:Urological Agents
Oxybutynin Child Neurogenic urinary bladder