A study evaluating and comparing the effectiveness of combination therapy – Duloxetine with darifenacin versus darifenacin as monotherapy on perception of symptoms, quality and standard of life in patients suffering with overactive bladder (OAB)

Abstract

: Overactive bladder is chronic debilitating condition, with physical, psychological, and economical consequences. Urinary vesicle tissue contains muscarinic receptors, M3 is principal mediator of detrusor contraction. Muscarinic receptor antagonists, comprises traditional pharmacological treatment. But due to non-selective inhibition, these agents, probably been related with safety and tolerability concerns. Drugs particular inhibiting sM3 receptor (Darifenacin) have potential to present effective relief while reducing side effects concerned with blockade of M1, M2 and M5 receptors. Duloxetine is Serotonin and nor-epinephrine reuptake inhibitor, leading increased concentration of 5-HT and NE in synaptic cleft, increases stimulation of pudendal motor neurons, thus increasing resting tone and contraction of urethral sphincter.: In present prospective, randomized, parallel group, comparative open label study with 60 OAB patients the combination therapy of Duloxetine with Darifenacin was equated with monotherapy using Darifenacin. The outcome thus analyzed using three different OAB-questionnaires and was statistically compared. : We demonstrated that addition of Duloxetine has shown better result outcome in symptoms as well as quality of life, though the difference of OAB-V8, OABss mean score was non-significant, but for OAB-qSF the reduction (percentage change) in mean score was more in treatment group II as compare to group I (w6:13.82±3.17% vs 12.13±3.24% & W12 29.99±5.40% Vs 25.56±5.17%) , and was statistically significant.(p<0.05).: Duloxetine has synergistic effect to Darifenacin, its ability to increase bladder capacity may be the reason for the improvement OAB symptoms, promising in controlling and treating symptoms either alone or in combination with anti-cholinergic drugs.