***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This study evaluated the efficacy , tolerability , and safety of darifenacin , an M3 selective receptor antagonist ( M3 SRA ) , in patients with overactive bladder ( OAB ) . In a multicenter , double-blind , placebo-controlled dose-ranging study , 439 adult OAB patients ( 85.4 % female ) were r and omized  to darifenacin controlled-release tablets 7.5 mg ( n = 108 ) , 15 mg ( n = 107 ) or 30 mg ( n = 115 ) qd , or placebo ( n = 109 ) for 12 weeks . Darifenacin significantly reduced the median number of incontinence episodes/week ( −68.7 , −76.5 , and −77.3 % from baseline at 7.5 , 15 , and 30 mg , respectively , vs −46 % with placebo , all p < 0.01 ) and dose relatedly improved micturition frequency , frequency and severity of urgency , nocturia , and bladder capacity . Darifenacin was well tolerated . Adverse events were commonly mild to moderate dry mouth and constipation . There were no safety concerns . Darifenacin is effective and well tolerated in the treatment of OAB , with 7.5 and 15 mg doses offering flexibility of dosing for optimal treatment outcome Overactive bladder ( OAB ) has a significant impact on a patient ’s health-related quality of life ( HRQoL ) . This study assessed the HRQoL of Japanese OAB patients following 12 weeks ’ treatment with tolterodine extended release ( ER ) or oxybutynin .  A total of 293 patients with symptoms of OAB were r and omized for treatment with tolterodine ER 4 mg once daily ( n=114 ) , oxybutynin 3 mg three times daily ( n=122 ) or a placebo ( n=57 ) . Treatment efficacy and safety assessment s were made over the 12-week period . HRQoL was assessed using the King ’s Health Question naire ( KHQ ) . Patients receiving tolterodine ER or oxybutynin showed a significant ( P<0.05 ) improvement in the Incontinence Impact , Role Limitations and most other KHQ domains compared with the placebo . These changes in HRQoL corresponded with significant ( P<0.05 ) improvements in micturition diary variables for patients receiving tolterodine ER and oxybutynin compared with placebo . Our findings demonstrate that Japanese OAB patients receiving tolterodine ER or oxybutynin experienced overall improvement in their quality of life The embarrassment and social stigma associated with urinary incontinence ( UI ) in overactive bladder syndrome ( OAB ) sufferers is a major reason for individuals to seek help for their condition . An analysis of 1,873 subjects with OAB with UI was conducted to assess the efficacy of solifenacin in reducing incontinence in a pooled population from four phase III clinical trials , stratified by severity of incontinence , urgency , and other key factors at baseline . Subjects were r and omized to either 5 or 10 mg of solifenacin once daily or placebo for 12 weeks . More than 50 % of the total population became continent at study end , with either dose of solifenacin ( P<0.01 vs placebo ) . Significant reductions in incontinence episodes and higher rates of attainment of continence vs placebo were observed irrespective of age or severity of incontinence or urgency at baseline with solifenacin treatment . Treatment was well tolerated , with the majority of adverse events being mild in nature . Solifenacin is an effective antimuscarinic agent for the treatment of incontinence associated with OAB PURPOSE In this phase 3 trial we assessed the efficacy of solifenacin 5 mg and 10 mg daily in patients with symptoms related to overactive bladder . In addition , we assessed the safety and acceptability of solifenacin . MATERIAL S AND METHODS The study was a multicenter , multinational , r and omized , double-blind , placebo controlled trial . Patients were r and omized to 12-week once daily treatment with solifenacin 5 mg , solifenacin 10 mg or placebo . The primary efficacy variable was changed from baseline to study end point in mean number of micturitions per 24 hours . Secondary efficacy variables included changes from baseline in mean number of urgency , nocturia and incontinence episodes per 24 hours , and mean volume voided per micturition . RESULTS Compared with changes obtained with placebo ( -1.59 ) , micturitions per 24 hours were statistically significantly decreased with solifenacin 5 mg ( -2.37 , p = 0.0018 ) and solifenacin 10 mg ( -2.81 , p = 0.0001 ) . A statistically significant decrease was observed in the number of incontinence episodes with both solifenacin doses ( 5 mg , p = 0.002 and 10 mg , p = 0.016 ) . This effect was also seen for episodes of urge incontinence ( 5 mg , p = 0.014 and 10 mg , p = 0.042 ) . Of patients reporting incontinence at baseline , fully 50 % achieved continence after treatment with solifenacin . Episodes of nocturia were statistically significantly decreased in patients treated with solifenacin 10 mg ( -0.71 , -38.5 % ) versus placebo ( -0.52 , -16.4 % , p = 0.036 ) . Episodes of urgency were statistically significantly reduced with solifenacin 5 mg ( -2.84 , -51 % , p = 0.003 ) and solifenacin 10 mg ( -2.90 , -52 % , p = 0.002 ) . Mean volume voided per micturition was statistically significantly increased with both solifenacin doses ( p = 0.0001 ) . Treatment with solifenacin was well tolerated . Dry mouth , mostly mild in severity , was reported in 7.7 % of patients receiving solifenacin 5 mg and 23 % receiving solifenacin 10 mg ( vs 2.3 % with placebo ) . CONCLUSIONS In this study treatment with solifenacin 5 mg and 10 mg once daily significantly improved all the major symptoms of overactive bladder including frequency , urgency and incontinence .  Solifenacin 10 mg also decreased the frequency of nocturia .  Solifenacin therapy was associated with a favorable tolerability profile and a low incidence of dry mouth , especially at the 5 mg starting dose OBJECTIVE To compare the efficacy and tolerability of extended-release formulations of oxybutynin chloride and tolterodine tartrate in women with overactive bladder . PATIENTS AND METHODS The OPERA ( Overactive bladder : Performance of Extended Release Agents ) trial was a r and omized , double-blind , active-control study performed at 71 US study centers from November 21 , 2000 , to October 18,2001 . Extended-release formulations of oxybutynin at 10 mg/d or tolterodine at 4 mg/d were given for 12 weeks to women with 21 to 60 urge urinary incontinence ( UUI ) episodes per week and an average of 10 or more voids per 24 hours .  Episodes of UUI ( primary end point ) , total ( urge and nonurge ) incontinence , and micturition were recorded in 24-hour urinary diaries at baseline and at weeks 2 , 4 , 8 , and 12 and compared . Adverse events were also evaluated . RESULTS Improvements in weekly UUI episodes were similar for the 790 women who received extended-release formulations of oxybutynin ( n = 391 ) or tolterodine ( n = 399 ) . Oxybutynin was significantly more effective than tolterodine in reducing micturition frequency ( P = .003 ) , and 23.0 % of women taking oxybutynin reported no episodes of urinary incontinence compared with 16.8 % of women taking tolterodine ( P = .03 ) . Dry mouth , usually mild , was more common with oxybutynin ( P = .02 ) . Adverse events were generally mild and occurred at low rates , with both groups having similar discontinuation of treatment due to adverse events . CONCLUSIONS Reductions in weekly UUI and total incontinence episodes were similar with extended-release formulations of oxybutynin and tolterodine . In the oxybutynin group , micturition frequency was significantly lower , and the percentage of women reporting no urinary incontinence episodes was significantly higher compared with the tolterodine group . Dry mouth was more common with oxybutynin , but tolerability was otherwise comparable , including adverse events involving the central nervous system PURPOSE We evaluated the efficacy , patient acceptability and side effect profile of tolterodine , a new antimuscarinic agent for treating bladder overactivity . MATERIAL S AND METHODS In our r and omized , placebo controlled , parallel group study 123 , 129 and 64 patients 18 years old or older with proved detrusor overactivity ( idiopathic detrusor instability or detrusor hyperreflexia ) were r and omized to receive 1 or 2 mg . tolterodine , or placebo , respectively , twice daily for 12 weeks . Main outcome measures were number of voids per 24 hours , urine volume per void and episodes of urge incontinence per 24 hours on a frequency-volume chart with detailed recording of side effects . RESULTS After 12 weeks of treatment mean number of voids per 24 hours plus or minus st and ard deviation decreased from 11.2 + /- 3.1 to 9.0 + /- 2.6 with the 2 mg . dosage ( p = 0.0045 versus placebo ) . At this dose mean urine volume per void increased from 155 + /- 52 to 190 + /- 70 ml . ( p < 0.0001 versus placebo ) , while mean number of incontinence episodes per 24 hours decreased from 3.6 + /- 4.0 to 1.8 + /- 3.1 ( p = 0.19 versus placebo ) . Similar efficacy was observed in patients receiving the 1 mg . dose . Severe dry mouth was reported by only 2 , 1 and 2 % of patients given the 1 and 2 mg . dose , and placebo , respectively . There was no clinical or electrocardiographic evidence of significant cardiac adverse events . CONCLUSIONS Tolterodine administration result ed in a significant decrease in the frequency of voiding and improved voided volume but it was seldom associated with troublesome or severe side effects A r and omized , double-blind , placebo-controlled , four-way crossover , safety study of darifenacin versus oxybutynin was carried out on 76 patients with overactive bladder ( OAB ) . Adults with OAB received 2 weeks each of darifenacin 15 and 30 mg once daily ( q.d . ) , oxybutynin 5 mg three times daily ( t.i.d . ) and placebo , in r and om sequence at 10-day intervals . Darifenacin and oxybutynin significantly reduced incontinence episodes , and the number/severity of urgency episodes ( all P<0.05 versus placebo ) . Improvements in OAB symptoms with darifenacin were dose-dependent . Dry mouth was less common with darifenacin 15 mg than oxybutynin ( 13 % and 36 % ; P<0.05 ) , while constipation was comparable ( 10 % and 8 % , respectively ) . Corresponding rates for darifenacin 30 mg were 34 % and 21 % , respectively . Patients only reported blurred vision or dizziness with oxybutynin ( 3 % and 2 % , respectively ) . Darifenacin ( 15 mg q.d . ) provides comparable efficacy with improved tolerability versus oxybutynin ( 5 mg t.i.d . ) in the treatment of patients with OAB To evaluate urinary symptom relief in women with mixed urinary incontinence ( MUI ) treated for up to 52 weeks with solifenacin succinate for overactive bladder ( OAB ) , as MUI is a complex and distressing condition reported by about a third of incontinent women , and with confirmed efficacy in OAB‐related urge incontinence , anticholinergic agents are a reasonable therapeutic option for such women OBJECTIVE To compare OAB symptom outcomes following initial r and omised treatment with solifenacin 5 mg or tolterodine ER 4 mg at the 4-week clinic-visit and again at 12 weeks for patients choosing to remain on this treatment dose from 4 weeks . METHODS A prospect i ve , double blind , double-dummy , two-arm , parallel-group , 12-week study ( The STAR study ) was conducted to compare the efficacy and safety of solifenacin 5/10 mg and tolterodine extended release ( ER ) 4 mg in OAB patients . RESULTS At 4 weeks mean improvements in OAB symptoms , including urgency , frequency ( primary variable ) , incontinence and nocturia , were larger in patients r and omised to solifenacin 5 mg ; with the difference for incontinence being statistically significant ( mean reduction in incontinence episodes/24 hrs in the solifenacin group of - 
    Output:
    
Tolterodine immediate release ( IR ) had a more favorable profile of adverse events than oxybutynin IR .
Regarding different dosages of IR formulations , dose escalation might yield some limited improvements in the efficacy but at the cost of significant increase in the rate of adverse events .
In the comparisons between IR and extended-release ( ER ) formulations , the latter showed some advantages , both in terms of efficacy and safety .
With regard to the route of administration , use if a transdermal route of administration does not provide significant advantage over an oral one .
With regard to IR formulations , dose escalation might yield some improvements in the efficacy with significant increase in the AE .