Spinal Cord Research Centre

Spinal Cord Research Centre
Report on Clinical Research Studies

by Orpha Schryvers, January 10, 2001

Two clinical research projects presently underway at the Rehabilitation Hospital involve medications that have recently come onto the market in Canada but whose effects or side effects have not been tested on people with SCI - tolterodine and sildenafil.

Tolterodine Study

Principal Investigator: Dr. Pat Nance
Co-Investigator: Dr. Karen Ethans
Funded by: The Christopher Reeve Paralysis Foundation

Tolterodine (Detrol) is a drug that works similarly to oxybutynin (Ditropan). Oxybutynin is prescribed often to people with SCI to decrease incontinence or increase the length of time between catheterizations. Initial studies have shown that tolterodine works as well as oxybutynin in relaxing the bladder muscle but that it has less of a side-effect of mouth dryness. Some people who take oxybutynin regularly complain of extreme dryness of the mouth. Previous clinical research has involved women with urge incontinence but not people with paralyzed bladders.

In this drug study, we are comparing the effects of tolterodine to oxybutynin and to placebo (a pill with no active drug in it). How well these drugs work is measured by urodynamic tests which show how much the bladder can hold and how much pressure there is in the bladder when it is full. Other measurements include the amount and number of catheterizations per day, the number of episodes of bladder incontinence per day, and the degree of mouth dryness.

The importance of this drug study is that if we can demonstrate evidence that a better treatment for the paralyzed bladder exists and is readily available, it would be of immediate benefit to individuals who have incontinence between catheterizations or who have to catheterize too frequently.

Sildenafil Study

Principal Investigator: Dr. Karen Ethans
Funded through the Manitoba Neurotrauma Initiative
by the Worker's Compensation Board of Manitoba and Manitoba Public Insurance

Sildenafil (Viagra) is a drug prescribed to men with erectile dysfunction, including men with SCI. Previous research studies have shown that this drug can work well for men with SCI who are able to have reflex erections, that is, it makes the erection stronger and last longer. However, there is some concern that Viagra may cause a temporary decrease in blood pressure in men with high levels of SCI who already have a low blood pressure. This has not been studied previously.

In this study trial we measure the blood pressure before and at one, two, three and four hours after taking the drug. The effect on blood pressure after taking Viagra 50 mg will be compared to Viagra 100 mg and to placebo (a pill with no active drug in it).

The importance of this drug study is to determine if it is safe for men with high level SCI to take this drug to improve their erectile ability.

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Posted January 11, 2001.