Duloxetine in the Treatment of Women with Urinary Incontinence: A Systematic Review and Meta-analysis of Efficacy Data from Randomized Controlled Clinical Trials

Abstract

Duloxetine is the only available agent for the medical treatment of stress urinary incontinence (SUI). In this systematic review, we analyzed the efficacy and safety of duloxetine treatment in women with SUI and stress-predominant mixed urinary incontinence (SPMUI). We searched the literature using OVID MEDLINE, Embase and ULAKBIM (Turkish database) databases for placebo-controlled studies on the use of duloxetine in women with SUI or SPMUI. Data on change in incontinence episode frequency (IEF), decrease in the number of continence pads used, increase in voiding interval (minute) and discontinuation rates due to adverse effects and lack of efficacy (%) were extracted. A total of 12 randomized controlled trials were included. Duloxetine treatment results in an 18% decrease in IEF and 16% decrease in the number of incontinence pads used compared to pre-treatment status. It also increases the time interval between the voids by 18 min. Duloxetine treatment was associated with higher treatment discontinuation rates compared with placebo. The reason for discontinuation was related to the side effects of the treatment rather than lack of efficacy. Duloxetine can be an effective treatment option in women with UI based on high-level evidence supporting its efficacy. Further studies with larger patient populations and longer durations of follow-up are required to assess its safety profile.

Keywords

• urinary incontinence
• stress
• urinary incontinence
• mixed
• duloxetine hydrochloride
• systematic review