Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Obstet Gynecol. May 10, 2015; 4(2): 24-39
Published online May 10, 2015. doi: 10.5317/wjog.v4.i2.24
Pioneering drugs for overactive bladder and detrusor overactivity: Ongoing research and future directions
Emilio Sacco, Salvatore Recupero, Riccardo Bientinesi, Giuseppe Palermo, Daniele D’Agostino, Diego Currò, Pierfrancesco Bassi
Emilio Sacco, Salvatore Recupero, Riccardo Bientinesi, Giuseppe Palermo, Daniele D’Agostino, Pierfrancesco Bassi, Urologic Clinic, Department of Surgical Sciences, “Agostino Gemelli” Hospital, Catholic University Medical School, 00168 Rome, Italy
Diego Currò, Institute of Pharmacology, Catholic University Medical School, 00168 Rome, Italy
Author contributions: Sacco E, Recupero S and Bientinesi R performed the search of articles; Sacco E, Recupero S, Bientinesi R, Palermo G and D’Agostino D performed the revision and selection of the retrieved articles and wrote the paper; Currò D and Bassi P performed a final supervision of the paper and contributed equally to the manuscript.
Conflict-of-interest: All authors have no conflict of interest related to the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Emilio Sacco, MD, PhD, Urologic Clinic, Department of Surgical Sciences, “Agostino Gemelli” Hospital, Catholic University Medical School, Largo Vito 1, 00168 Roma, Italy. emilio.sacco@gmail.com
Telephone: +39-6-30155290 Fax: +39-6-30155975
Received: December 20, 2014
Peer-review started: December 21, 2014
First decision: January 20, 2015
Revised: January 31, 2015
Accepted: April 10, 2015
Article in press: April 14, 2015
Published online: May 10, 2015
Abstract

The ongoing research on pioneering drug candidates for the overactive bladder (OAB) aimed to overcome the limitations of currently licensed pharmacotherapies, such as antimuscarinics, β3-adrenergic agents, and botulinum neurotoxin, has been reviewed performing a systematic literature review and web search. The review covers the exploratory agents alternative to available medications for OAB and that may ultimately prove to be therapeutically useful in the future management of OAB patients based on preclinical and early clinical data. It emerges that many alternative pharmacological strategies have been discovered or are under investigation in disease-oriented studies. Several potential therapeutics are known for years but still find obstacles to pass the clinical stages of development, while other completely novel compounds, targeting new pharmacological targets, have been recently discovered and show potential to translate into clinical therapeutic agents for idiopathic and neurogenic OAB syndrome. The global scenario of investigational drugs for OAB gives promise for the development of innovative therapeutics that may ultimately prove effective as first, combined or second-line treatments within a realistic timescale of ten years.

Keywords: Detrusor overactivity, Drug therapy, Lower urinary tract symptoms, Overactive bladder, Urinary incontinence

Core tip: The forefront of global research scenario of investigational drug candidates for the management of patients with overactive bladder and detrusor overactivity was reviewed. Among a huge amount of exploratory compounds with completely new mechanisms of action, some promising pharmacological principles show potential to translate into novel therapeutics to be clinically used as first-line alternative treatments, or in combination with established drugs, or as second-line treatments in refractory patients.