Purpose Previous studies have included a limited number of randomized controlled trials (RCTs) and compared limited parameters after treatment with imidafenacin and other anticholinergic drugs (ADs) for overactive bladder syndrome (OAB), and controversy about the superiority of these ADs still remains. We aim to update the evidence and provide better clinical guidance. Methods A systematic search of PubMed, Embase, ClinicalTrial.gov and Cochrane Library Central Register of Controlled Trials was conducted from January 2007 to April 2019. Meta-analysis of all published RCTs comparing imidafenacin with other ADs in patients with OAB was performed. The primary outcomes were the changes in OAB symptoms and OAB symptom score (OABSS). Secondary outcomes included adverse events (AEs) and the dropout rate related to AEs. Results A total of 6 studies including 7 RCTs involving 1430 patients with mean follow-up of 23.43 weeks were included. All ADs improved OAB symptoms. Regarding efficacy, these drugs had similar efficacy in voids, urgency episodes, urgency incontinence episodes, incontinence episodes and OABSS. However, imidafenacin performed better in the reduction of nocturia episodes (MD = –0.24, 95% CI –0.44 to –0.04, P = 0.02). Moreover, imidafenacin was associated with a statistically lower dry mouth rate (RR = 0.87, 95% CI 0.75–1.00, P = 0.04), lower constipation rate (RR = 0.68, 95% CI 0.50–0.93, P = 0.01) and lower AE-related withdrawal rate (RR = 0.51, 95% CI 0.29–0.89, P = 0.02). There was no significant difference in terms of other complications. Conclusions In conclusion, imidafenacin was comparable to other ADs in the treatment of OAB. Moreover, imidafenacin presented a lower dry mouth rate, lower constipation rate and higher adherence and persistence.

中文翻译：

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对于膀胱过度活动症患者，咪达那新是目前抗毒蕈碱药物的替代品吗？

目的 先前的研究包括数量有限的随机对照试验 (RCT)，并比较了咪达那新和其他抗胆碱能药物 (ADs) 治疗膀胱过度活动症 (OAB) 后的有限参数，关于这些 ADs 的优越性的争议仍然存在。我们的目标是更新证据并提供更好的临床指导。方法 2007 年 1 月至 2019 年 4 月，系统检索了 PubMed、Embase、ClinicalTrial.gov 和 Cochrane Library Central Register of Controlled Trials。对所有已发表的比较咪达那新与其他 AD 用于 OAB 患者的 RCT 进行了荟萃分析。主要结果是 OAB 症状和 OAB 症状评分 (OABSS) 的变化。次要结局包括不良事件 (AE) 和与 AE 相关的退出率。结果共纳入6项研究，7项RCT，涉及1430名患者，平均随访23.43周。所有 AD 均改善了 OAB 症状。关于疗效，这些药物在排尿、尿急发作、急迫性尿失禁、尿失禁和 OABSS 中具有相似的疗效。然而，咪达那新在减少夜尿发作方面表现更好（MD = –0.24, 95% CI –0.44 至 –0.04, P = 0.02）。此外，咪达那新与统计学上较低的口干率（RR = 0.87, 95% CI 0.75–1.00, P = 0.04）、较低的便秘率（RR = 0.68, 95% CI 0.50–0.93, P = 0.01）和更低相关AE 相关退出率（RR = 0.51, 95% CI 0.29–0.89, P = 0.02）。其他并发症无显着差异。结论 总之，咪达那新在 OAB 的治疗中与其他 AD 具有可比性。而且，