Comparative assessment of oral medications for overactive bladder in older adults: a systematic review and network meta-analysis

To systematically compare the efficacy and safety of medications in elderly with overactive bladder. Pubmed, Embase, Web of Science, and the Cochrane Register of Clinical Trials databases were systematically searched from database inception to July 25, 2023, and randomized, controlled, double-blind trials for overactive bladder in the elderly were screened according to the protocol. Data were analyzed using Stata17.0. In terms of reducing Micturitions, the interventions were ranked: trospium chloride (TRO), fesoterodine (FES) 4/8 mg, vibegron (VIB), mirabegron (MIR) 25/50 mg, tolterodine ER (TOL) 4 mg, placebo (PBO), of which only TOL showed no significant difference compared to placebo; Forsafety, the TEAE of TOL 4/8 mg had the highest incidence and was significantly different from others; MIR, VIB, and FES 4mg were well-tolerated regarding dry mouth and constipation; TOL 4 mg, FES 4/8 mg, and VIB showed a statistically increase from placebo for headache and FES 4/8mg and MIR 25 mg showed a statistically increase for dizziness. TRO 60 mg has the best efficacy in reducing micturitions, but increases the incidence of dry mouth and constipation; VIB and MIR are well tolerated in dry mouth and constipation, but may increase the risk of headache or dizziness.