Mouth and eye dryness are frequently reported by patients with multiple sclerosis (MS) as side effects of antimuscarinic drugs used for neurogenic overactive bladder. We evaluated the impact of antimuscarinic drugs prescription on these symptoms.
MS patients consulting for overactive bladder were included. Xerostomia were evaluated at baseline and thirty days after treatment by self-reporting questionnaires (Xerostomia Quality of Life [X-Qol] and Xerostomia Questionnaire [XQ]), by salivary flow rate and sugar test. Xerophtalmia were evaluated by a self-reporting questionnaire (Ocular Surface Disease Index [OSDI]) and Schirmer test. Iatrogenic anticholinergic impregnation was evaluated by the Anticholinergic Drug Scale.
From January to December 2014, 35 patients were included. Mean age was 50.1±10.2 years, mean EDSS=4.9. Mean anticholinergic impregnation was 0.6±1.0. Before treatment, none correlation was found between anticholinergic impregnation and other parameters. Twenty-two patients were evaluated after treatment. At baseline and thirty days after treatment, mean scores were respectively: 0.78±0.51 and 0.73±0.43 (P=0.67) for X-Qol, 9.22±11.8 and 7.03±11.4 (P=0.32) for XQ, 18.8±14.9 and 13.9±11.6 (P=0.06) for OSDI. Mean salivary flow rates were respectively 1.54±1.11 and 1.22±1.3 (P=0.53), positive sugar tests concerned respectively 68% and 55% of patients (P=0.53), and positive Schirmer test concerned 50% before and after treatment.
Eye and mouth dryness exist in our MS population, even before prescription of antimuscarinic treatment, and is not getting worse after prescription. Those symptoms should not be the reason to stop an efficient treatment, but should be the reason to find and treat their aetiology.
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Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2016 Dec 07 [Epub ahead of print]
L Weglinski, P Manceau, M Thomas-Pohl, F Le Breton, G Amarenco
Service de neuro-urologie, hôpital Tenon, groupe de recherche clinique en neuro-urologie (GREEN), UPMC université Paris 06, Sorbonne universités, AP-HP, GRC 01, 4, rue de la Chine, 75020 Paris, France. Electronic address: ., Service de neuro-urologie, hôpital Tenon, groupe de recherche clinique en neuro-urologie (GREEN), UPMC université Paris 06, Sorbonne universités, AP-HP, GRC 01, 4, rue de la Chine, 75020 Paris, France.