Evaluation of Cognitive Function in Healthy Older Subjects Treated with Fesoterodine

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Gary G. Kay, PhD; Paul Maruff, PhD; David Scholfield, MBBS; Bimal Malhotra, PhD; Laurence Whelan, PhD; Amanda Darekar, MSc; Diane L. Martire, MD, MPH

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Postgraduate Medicine:

Volume 124 No. 3


Clinical Focus

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DOI: 10.3810/pgm.2012.05.2543
Objective: To evaluate the cognitive effects of fesoterodine 4 and 8 mg versus placebo in healthy older adults. Methods: This was an active- and placebo-controlled, double-blind, double-dummy crossover study conducted using healthy volunteers (aged 65–85 years) with baseline Mini–Mental State Examination score ≥ 26. The study comprised 4 treatment periods: fesoterodine 4 mg for 6 days; fesoterodine 4 mg for 3 days followed by fesoterodine 8 mg for 3 days; placebo for 6 days; and placebo for 6 days with alprazolam 1 mg on day 6. The treatment sequence was randomized, with a 3- to 6-day washout between periods. Subjects completed computer-based cognitive assessments and the Rey Auditory Verbal Learning Test on day 1 (before dosing) and day 6 (after dosing) of each period. The primary endpoint was the Detection task; secondary endpoints were the Identification task, 1-card learning task, Continuous Paired Associate Learning task, Groton Maze Learning Task, and the Rey Auditory Verbal Learning Test. Results: Among 18 subjects in the per protocol set, changes from baseline to day 6 with fesoterodine 4 and 8 mg were not significantly different from placebo for any endpoint (P > 0.05); alprazolam produced significant impairment in all endpoints versus placebo (P < 0.05). No serious adverse events were reported; the most common adverse events were dry mouth for fesoterodine and sedation for alprazolam. No sedation was reported with fesoterodine. Conclusion: In healthy older adults, fesoterodine 4 and 8 mg once daily had no statistically significant effects versus placebo on any cognitive function assessed, including memory; alprazolam 1 mg produced statistically significant deterioration.

Keywords: fesoterodine; antimuscarinic; elderly; cognition; memory