a Urology Department, Agostino Gemelli Academic Hospital Foundation IRCCS , Catholic University School of Medicine of Rome , Rome , Italy.
Expert Opin Pharmacother. 2018 Dec;19(18):1989-1997. doi: 10.1080/14656566.2018.1532502. Epub 2018 Oct 10.
The pharmacological treatment of urinary incontinence and overactive bladder (OAB) has been, for a longer time, based on antimuscarinic agents. In recent years, two other pharmacological principles have been introduced for the treatment of OAB and urgency urinary incontinence: the β3-adrenergic agent mirabegron and botulinum neurotoxin. Meanwhile, there is lack of effective drugs for the treatment of stress incontinence.
This literature review presents synthetic compounds aimed to treat female urinary incontinence that are in phase II-III clinical development.
Antimuscarinic agents will continue to represent the current gold standard for the first-line pharmacological management of OAB and urgency urinary incontinence. The class of β3-agonists will certainly expand with the discovery and clinical development of novel agents. Combination therapy of antimuscarinic agents and β3-agonists could offer an alternative treatment in these patients, including those with symptoms refractory to first-line monotherapy. A huge number of preclinical studies are underway in this field exploring the therapeutic potential of many novel compounds while some have advanced to clinical phases of development.
长期以来,治疗尿失禁和膀胱过度活动症(OAB)的药物疗法一直基于抗毒蕈碱药物。近年来,又引入了另外两种治疗 OAB 和急迫性尿失禁的药理学原理:β3-肾上腺素能激动剂米拉贝隆和肉毒杆菌神经毒素。同时,对于压力性尿失禁的治疗,仍缺乏有效的药物。
本文综述了处于 II-III 期临床开发阶段的用于治疗女性尿失禁的合成化合物。
抗毒蕈碱药物将继续作为 OAB 和急迫性尿失禁一线药物治疗的金标准。β3-激动剂类药物的发现和临床开发肯定会进一步扩展。抗毒蕈碱药物和β3-激动剂的联合治疗可能为这些患者提供一种替代治疗方法,包括对一线单药治疗无反应的患者。在这一领域,大量的临床前研究正在进行中,探索了许多新型化合物的治疗潜力,其中一些已进入临床开发阶段。