Urinary Incontinence
Urinary Incontinence (UI) is a common illness, particularly in the rapidly growing elderly population. UI is defined as the uncontrollable loss of urine from the bladder and is the primary cause of institutionalization of the elderly. The syndrome is comprised primarily of three subtypes: urge incontinence, stress incontinence, and mixed incontinence. Urge incontinence, in which the patient cannot control the emptying of the bladder appropriately after the recognition of the need to urinate, is the most common and socially disturbing problem in the elderly. Stress incontinence is most commonly seen in post-partum females and post-urethral procedure males, in which there are physical changes imposed upon the urinary tract that cause urinary loss with increased abdominal pressure, such as coughing. Mixed incontinence is a combination of urge and stress incontinence.
Urinary incontinence remains a significantly under-diagnosed and sub-optimally treated disease. Of the 15 million patients with significant urge and mixed UI in the United States, only 20% receive proper diagnosis, and only 10% actually receive treatment. The anticholinergic agents Detrol® and Ditropan XL® currently dominate the UI market with sales expected to exceed $900 million in 2002. Many patients, however, are unable to tolerate the side effects associated with these anticholinergic drugs. Efficacy is also sub-optimal as both agents reduce but do not eliminate incidents of UI.
We believe there is a significant opportunity for compounds with reduced side effects and/or increased efficacy over current anticholinergic agents.