Applying a gel containing the anti-spasmodic agent oxybutynin to the skin is safe and effective for women with overactive bladder, according to a study reported here at the annual meeting of the American Urological Association.

Overactive bladder can be disabling and is associated with a marked decrease in health-related quality of life as well as higher rates of depression, Dr. Roger Dmochowski noted. The condition affects both men and women, but women experience more severe symptoms earlier in life than men.

The gel, which goes by the brand name Gelnique, is applied “once daily to rotating sites on the abdomen, upper arm/shoulders and thigh.” Dmochowski of Vanderbilt University Medical Center in Nashville, Tennessee, and others tested it in some 700 women with symptoms of overactive bladder.

The women were randomly assigned to treatment with the oxybutynin gel or an inactive placebo, which they applied once a day for 12 weeks.

By the end of the study period, 27 percent of the women treated with oxybutynin gel achieved complete continence compared with 15.6 percent treated with placebo.

The average daily number of mean urinary episodes dropped by 2.8 episodes with active treatment compared with 2.0 episodes with placebo.

There was also a greater reduction in incontinence, which dropped by 3.0 episodes a day with oxybutynin and by 2.5 episodes a day with placebo.

There were no serious treatment-related adverse events. The most common side effect with oxybutynin gel was dry mouth, occurring in 7.4 percent of the women compared with 2.8 percent with placebo. Itchiness occurred at the application site in 2.3 percent of the study group and 0.9 percent of the placebo group.

The results confirm that the oxybutynin gel “is a novel treatment approach with strong efficacy and excellent tolerability” for women with overactive bladder, Dmochowski commented during the presentation of his team’s findings.

“Women with overactive bladder often experience severe symptoms at a young age, so it’s important that we have an effective treatment that is both well tolerated and convenient for our female patients,” he said.

By Martha Kerr
CHICAGO (Reuters Health)