Toviaz (fesoterodine) is a competitive muscarine receptor antagonist, which has achieved marketing authorisation in treatment of symptoms that occur in patients with an overactive bladder syndrome, such as increased urinary frequency and/or imperious urgency and/or urgency incontinence.
IRF states that Toviaz increases the options in treatment of patients with overactive bladder syndrome. There is little effect of the treatment that through 12 weeks reduces the daily urination with one in patients who have approximately 12 urinations per day. Simultaneously the number of daily incontinence episodes is reduced with approximately 1 in patients who have inadequate 4 incontinence episodes a day.
When studies are pooled for analysis, post hoc studies show that these small changes have great importance in the quality of life in patients with overactive bladder syndrome. This matters against dry mouth and other anticholinerge side effects.
Unfortunately Toviaz have the same problems as the analogue Detrusitol (tolterodin) in that the effect is minor and it has concurrent side effects. It is regrettable that it is not possible to identify any obvious improvement, when Toviaz is compared to Detrusitol. It may have been better with a new treatment principle in stead of a second “me too product”. Finally it is desirable with a longer placebo controlled follow-up than 12 weeks.
Toviaz is only compared to Detrusitol. The other antimuscarine drugs are equal and cost approximately the same except from Spasmoplex (trospium chloride) and Kentera (oxybutynin). Spasmoplex is a little cheaper, but in return it has a disadvantage because it must be dosed twice daily. Kentera is significant more expensive than the other, but it gives an opportunity for transdermal administration.
Toviaz was marketed the 2nd of June 2008.