Urologiia (Moscow, Russia : 1999) · 2026
[Evaluation of tolerability and cognitive safety of trospium chloride in the treatment of overactive bladder: a systematic review and meta-analysis].
СтатьяМетаанализСистематический обзорАннотация на английскомНазвание и аннотация: Перевод в очереди
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Kuzmin I V, Slesarevskaya M N, Al-Shukri S Kh
Аннотация
INTRODUCTION: Overactive bladder (OAB) is one of the most common lower urinary tract dysfunctions, significantly impairing the quality of life of patients. Pharmacotherapy is the leading treatment for OAB; however, poor tolerability of antimuscarinic drugs prescribed for this condition hinders clinical efficacy in a significant number of patients.
OBJECTIVE: To evaluate the tolerability and cognitive safety of the anticholinergic drug trospium chloride (TCh) in the treatment of OAB in adults and children.
MATERIALS AND METHODS: The study was conducted in accordance with the PRISMA criteria. A search of eLibrary, PubMed, EMBASE, Web of Science, and the Cochrane Library was performed for the period 1991-2025. Randomized and non-randomized controlled trials, as well as prospective observational studies, were included in the analysis. A control group was required in adult studies. A total of 23 studies (15 in adults, 8 in children) were included in the analysis. A total of 2,244 patients (1,934 adults, 310 children) received TCh.
RESULTS: Most adverse events (AEs) with TCh were due to the drugs systemic antimuscarinic effect. The most common AEs were dry mouth (OR 3.75; 95% CI 2.83-4.97; NNH = 6.0) and constipation (OR 2.69; 95% CI 1.72-4.19; NNH = 17.1). The incidence of peripheral AEs with TCh is comparable to that with other antimuscarinic agents used to treat OAB, with the exception of oxybutynin, which is significantly less well-tolerated. Unlike other anticholinergic drugs, TCh does not affect the central nervous system or cause cognitive impairment. TCh was well tolerated in children at age-appropriate doses.
CONCLUSION: The results of the study demonstrate good tolerability of TCh in adults and children. A significant advantage of TCh is its cognitive safety. Along with its clinical efficacy, this allows TCh to be considered as a first-line anticholinergic therapy in adults with OAB, particularly in elderly patients and those at high risk of cognitive impairment. Further studies of the long-term safety of TCh in patients of different age groups are warranted.
OBJECTIVE: To evaluate the tolerability and cognitive safety of the anticholinergic drug trospium chloride (TCh) in the treatment of OAB in adults and children.
MATERIALS AND METHODS: The study was conducted in accordance with the PRISMA criteria. A search of eLibrary, PubMed, EMBASE, Web of Science, and the Cochrane Library was performed for the period 1991-2025. Randomized and non-randomized controlled trials, as well as prospective observational studies, were included in the analysis. A control group was required in adult studies. A total of 23 studies (15 in adults, 8 in children) were included in the analysis. A total of 2,244 patients (1,934 adults, 310 children) received TCh.
RESULTS: Most adverse events (AEs) with TCh were due to the drugs systemic antimuscarinic effect. The most common AEs were dry mouth (OR 3.75; 95% CI 2.83-4.97; NNH = 6.0) and constipation (OR 2.69; 95% CI 1.72-4.19; NNH = 17.1). The incidence of peripheral AEs with TCh is comparable to that with other antimuscarinic agents used to treat OAB, with the exception of oxybutynin, which is significantly less well-tolerated. Unlike other anticholinergic drugs, TCh does not affect the central nervous system or cause cognitive impairment. TCh was well tolerated in children at age-appropriate doses.
CONCLUSION: The results of the study demonstrate good tolerability of TCh in adults and children. A significant advantage of TCh is its cognitive safety. Along with its clinical efficacy, this allows TCh to be considered as a first-line anticholinergic therapy in adults with OAB, particularly in elderly patients and those at high risk of cognitive impairment. Further studies of the long-term safety of TCh in patients of different age groups are warranted.