Fesoterodine: Pharmacological Properties and Clinical Implications

Fesoterodine was recognized for its efficacy and safety in treating overactive bladder (OAB), particularly in the elderly. A systematic review of 205 articles, with 45 selected, highlighted four key pharmacological properties: high and nearly equal affinity for M2 and M3 muscarinic receptors, poor penetration of the blood-brain barrier, rapid conversion to its active metabolite without hepatic first-pass activation, and an extended-release formulation. These properties contributed to its classification as beneficial (B) by LUTS-FORTA 2014, based on six studies involving 2,511 elderly patients, demonstrating low cognitive impact and clear efficacy.