Comparisons of the therapeutic safety of seven oral antimuscarinic drugs in patients with overactive bladder: a network meta-analysis.

OBJECTIVES: This network meta-analysis aimed to assess the safety profiles of seven commonly used oral antimuscarinic drugs (darifenacin, fesoterodine, imidafenacin, oxybutynin, propiverine, solifenacin, and tolterodine) in patients with overactive bladder (OAB). METHODS: PubMed, Cochrane Library, EMBASE, CNKI, and Wanfang databases were searched for randomized controlled trials (RCTs). Studies comparing one or more antimuscarinic drugs for treating OAB with reported adverse effects (AEs) were eligible. Data were extracted, and a network meta-analysis was performed by two authors independently. RESULTS: Forty-five RCTs and 124,587 patients were included. The results demonstrated that tolterodine had better safety outcomes for 7 out of 12 major AEs, including dry mouth, constipation, urinary retention, dizziness, urinary tract infection, dry eyes, and dry skin. Darifenacin, fesoterodine, imidafenacin, oxybutynin, and solifenacin presented comparable safety profiles. CONCLUSIONS: Tolterodine may be preferable as it showed a reduced association with important AEs. Darifenacin, fesoterodine, imidafenacin, oxybutynin, and solifenacin have similar safety profiles in treating patients with OAB. Taken together, this analysis provides a valuable overview of the therapeutic safety for oral antimuscarinic drugs and is useful for personalized medicine in patients with OAB.Trial registration: This trial was retrospectively registered at INPLASY (https://inplasy.com/) with the registration number 202170095.

Malat-1 expression in bladder carcinoma tissues and its clinical significance.

OBJECTIVE: To investigate the expression of metastasis-associated lung adenocarcinoma transcript 1 (Malat-1) in bladder carcinoma and its relationship with clinicopathological characteristics and prognosis. METHODS: Specimens were collected from 90 patients with bladder carcinoma who underwent urological surgery in our hospital. Twenty patients diagnosed with benign prostatic hyperplasia were selected as the negative control. The expression of Malat-1 was detected by real-time reverse transcription PCR, and its relationship with clinicopathological factors and prognosis was analyzed. RESULTS: The expression of Malat-1 in bladder carcinoma tissues (2.55±0.31) was higher than that in adjacent tissues (1.62±0.42) and normal bladder mucosa tissues (0.84±0.06); the differences were statistically significant (t=13.647 and 27.302, both P<0.001). The high expression rate of Malat-1 in bladder carcinoma tissues (86.67%) was significantly higher than that in adjacent tissues (22.22%) and normal bladder mucosa tissues (5.00%; P=0.000 and 0.000). The high expression rate of Malat-1 was correlated with age, tumor staging, degree of differentiation and lymph node metastasis (P=0.018, 0.000, 0.000, and 0.000). The median survival time and the 1-year, 3-year and 5-year survival rates of patients with high Malat-1 expression were lower than those with low expression of Malat-1 (P=0.006, 0.011, 0.000 and 0.002). High expression of Malat-1 is an independent risk factor for poor overall survival (OS) in bladder cancer patients. CONCLUSION: Overexpression of Malat-1 in bladder carcinoma tissues is associated with malignant biological characteristics and poor prognosis of patients.