Urinary Urge Incontinence

Abstract

Urinary incontinence, the involuntary loss of urine, is a prevalent medical condition that affects men, women and children of all ages. However, the incidence of incontinence tends to increase with age and it is particularly widespread in the elderly. Four major categories of incontinence have been defined: urge incontinence, stress incontinence, overflow incontinence and functional incontinence. Urinary urge incontinence (UUI) is the largest category affecting both men and women and is also the most amenable to pharmacological intervention. A large number of patients suffer from this condition (ca. 20 million). However, existing pharmaceutical agents for the treatment of UUI either lack efficacy or are poorly tolerated and, consequently, the condition is poorly controlled. Thus, there is a high medical need for efficacious, well-tolerated drugs to treat this condition. ?he commercial potential for novel, effective agents is considerable, given the number of patients involved and the growth associated with an ageing population. Three classes of drug are currently used in the treatment of UUI: antimuscarinics, antispasmodics and mixed antimuscarinic/antispasmodic medic agents. None of the agents currently marketed for the treatment of UUI was developed specifically for this indication, and only two drugs, the antimuscarinic, oxybutynin, and the antispasmodic, flavoxate, are approved by the FDA for the treatment of UUI in adults. Effective drug therapy for UUI must reduce the number of incontinence episodes and the associated symptoms of urgency and increased urinary frequency. A number of novel agents are currently being developed for the treatment of UUI. Some of these are compounds that offer incremental improvements in existing mechanistic classes whereas others target completely novel mechanisms. The identification of novel, effective, well-tolerated agents for the treatment of UUI, which will bring a much needed improvement in the quality of life of patients, represents a major challenge. However, the development of such agents represents a considerable commercial opportunity for the pharmaceutical industry.