[Efficacy and safety of the polypeptide drug Vesusten in the correction of neurogenic LUTS in Multiple Sclerosis. Results of the pilot study].

Abstract

Objective: The purpose of this study was to evaluate the effectiveness of the drugs Solifenacin and Vesusten in relation to the treatment of neurogenic bladder overactivity in multiple sclerosis (MS).

Materials and methods: A prospective, single-site, single-center, placebo-controlled, parallel-group, comparative clinical trial was conducted. The study included 41 MS patients of both sexes aged 18-50 years with urodynamically confirmed detrusor overactivity. Data were obtained by completing a voiding diary. Clinical data were assessed before taking the drugs, during a monthly course of therapy and after a month of observation after the end of treatment. The results were processed by nonparametric methods of statistical analysis.

Results: Both drugs are effective in patients with MS to correct neurogenic bladder overactivity. At the same time, in comparison with Solifenacin, Vesusten showed better clinical efficacy in relation to clinical manifestations of overactive bladder (OAB). Pollakiuria and urgency also decreased significantly. The best profile of maintaining the therapeutic effect was observed with Vesusten in relation to the frequency of urinary incontinence and OAB syndrome. The results of the study established that Solifenacin and Vesusten can cause adverse events, the frequency and nature of which correspond to the data declared by the manufacturers.

Discussion: Considering the clinical features of MS, the priority in treatment, in addition to effectiveness, is maximum conservative therapy. The currently recommended therapy for neurogenic bladder overactivity is limited to the use of M-anticholinergics and intradetrusor administration of botulinum toxin type A drugs. At the same time, multiple side effects of such treatment are observed with a high frequency. The emergence of a new effective therapeutic agent is a promising direction for the treatment of neurogenic bladder overactivity in patients with MS.

Conclusions: Both Solifenacin and Vesusten are effective therapeutic options for the management of neurogenic bladder overactivity in MS. However, Vesusten has a more significant therapeutic profile, expressed in the correction of pollakiuria, urge incontinence and urgency. After completion of therapy, Vesusten, in comparison with Solifenacin, demonstrates the retention of a strong therapeutic effect. Based on the combination of various assessment parameters of a voiding diary, Vesusten is a priority therapeutic agent that determines the best quality of life profile for patients with MS.