Findings from two large trials suggest that the bladder-control drug Detrol (known generically as tolterodine) is no better than inactive “placebo” for treating Urinary Incontinence resulting from bladder spasms in children.

However, the researchers believe that the apparent lack of benefit with Detrol may have been due to a high response rate in the placebo group, and to under-dosing of the active drug. Given that Detrol’s effects were most pronounced in children weighing 35 kg or less, the team suggests that dosing the drug according to weight may improve outcomes.

The findings, which appear in the Journal of Urology, are based on trial results that included 711 children between the ages of 5 and 10 years old who were treated with Detrol or placebo daily for 12 weeks.

Compared with placebo, Detrol did not have a significant effect on the number of incontinence episodes per weak or other measures of incontinence, Dr. Rien J. M. Nijman, from Groningen University Hospital in the Netherlands, and colleagues report.

Detrol was well tolerated and no serious side effects were observed, the investigators point out.

While it may be worthwhile to give Detrol a try in older children with daytime incontinence, it may be unnecessary for younger kids, according to a related editorial.

Assuming there are no neurologic abnormalities, parents should “remain optimistic” that the problem will ultimately resolve on its own, Dr. Saul P. Greenfield, from the Women & Children’s Hospital of Buffalo in New York, notes.

SOURCE: Journal of Urology, April 2005.