Innovative pharmacotherapies for women with overactive bladder: where are we now and what is in the pipeline?

Emilio Sacco, Riccardo Bientinesi

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Introduction and hypothesis: The impressive prevalence of overactive bladder (OAB) and the relevant limitations of current treatments urge the need for novel therapeutic approaches. Methods: A systematic literature and web search was performed to identify investigational drugs that entered the early and late phases of clinical development for women with OAB symptoms. Results: Approved pharmacological therapies for OAB (antimuscarinics, beta-3 agonists, and botulinum toxin) are evolving with the development of alternative administration methods, combination strategies, and novel compounds, expected to improve effectiveness, bladder selectivity, and dose flexibility. A wealth of investigational compounds, developed with both public and companies’ indoor nonclinical disease-oriented studies, entered the early and late stages of clinical development in the last decade. Most non-anticholinergic compounds in ongoing clinical trials target central and peripheral neurotransmitter receptors involved in neurological modulation of micturition, nonadrenergic-noncholinergic mechanisms, cyclic nucleotide metabolism, different subtypes of ion channels or peripheral receptors of prostaglandins, vanilloids, vitamin D3, and opioids. Fascinating advances are ongoing also in the field of genetic therapy. Conclusions: New pharmaceutical formulations and drug combinations are expected to be available in the next decade in order to overcome the limitations of current drugs for OAB. Although proof-of-concept, patient-oriented studies yielded disappointing results for several tentative drugs, a lot of clinical research is ongoing that is expected to provide clinicians with novel therapeutic agents in the near future.
Original languageEnglish
Pages (from-to)629-640
Number of pages12
JournalINTERNATIONAL UROGYNECOLOGY JOURNAL
Volume26
DOIs
Publication statusPublished - 2015

Keywords

  • Adrenergic beta-3 Receptor Agonists
  • Botulinum Toxins, Type A
  • Calcium Channels
  • Clinical trials
  • Detrusor overactivity
  • Development pipeline
  • Drug Discovery
  • Drug therapy
  • Drugs, Investigational
  • Female
  • Genetic Therapy
  • Humans
  • Muscarinic Antagonists
  • Overactive bladder
  • Potassium Channels
  • Receptors, Calcitriol
  • Receptors, Opioid
  • Receptors, Prostaglandin
  • Receptors, Tachykinin
  • Serotonin Uptake Inhibitors
  • Serotonin and Noradrenaline Reuptake Inhibitors
  • TRPV Cation Channels
  • Urinary Bladder, Overactive
  • Urinary incontinence

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