Solifenacin (VESIcare®) is the second-line anti-muscarinic medication of choice for my patients with overactive bladder (oxybutynin being my initial choice). However, currently, it remains unlicensed for use in children. Newgreen et al. have evaluated the long-term safety and efficacy of once daily solifenacin suspension in children and adolescents.. They report a 40-week, open-label extension of a 12-week double-blind, placebo-controlled trial. A total of 119 children (5-12 years of age) and 29 adolescents (12-18 years) of age were enrolled. It took place between October 2012 and October 2014 in 16 countries worldwide. One hundred and twenty-two patients completed the study. Drug-related adverse events were approximately 35% (constipation, dry mouth, nausea and electrocardiogram (ECG) QT elongation). Only 10.2% of children and 13.8% of adolescents discontinued their medication through adverse events. There were no cases of urinary retention or increases in post-void residual volume. There was an absence of central nervous system associated side-effects (which contrasts with oxybutynin). All efficacy parameters (number of wetting episodes per 24 hours, voids per 24 hours, incontinence-free days per week and grade three or four urgency episodes) observed by three weeks were further improved and / or maintained throughout the study period. They conclude that once-daily solifenacin suspension is well-tolerated for up to one year in children and adolescents with overactive bladders. The majority of children were titrated to a dose of 10mg once daily.

Long-term safety and efficacy of solifenacin in children and adolescents with overactive bladder.
Newgreen D, Bosman B, Hollestein-Havelaar A, et al.
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Neil Featherstone

Cambridge University Hospitals NHS Foundation Trust (Addenbrookes Hospital).

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