Mirabegron相較solifenacin在乾燥症併膀胱過動症的患者有更好的耐受性

曾浩翔1、吳柏樟2,3,4,5  楊凱介2、張詩欣2、藍忠亮2、黃柏豪2、黃春明2、黃志平1 、陳得源2、鄒頡龍1

1中國醫藥大學附設醫院 泌尿部,2風濕免疫中心; 3國立中興大學 轉譯醫學博士學位學程, 4榮興轉譯醫學研究中心; 5中國醫藥大學醫學院

Mirabegron is More Tolerable than Solifenacin in Sjogren’s Syndrome Patients with Overactive Bladder Symptoms

Chen Hao Xiang1, Po-Chang Wu2,3,4,5, Kai-Jieh Yeo2, Shih-Hsin Chang2, Joung-Liang Lan2, Po-Hao Huang2, Chung-Ming Huang2, Chi-Ping Huang1, Der-Yuan Chen2, Eric Chieh-Lung Chou1

1Department of Urology, 2 Rheumatology and Immunology Center, China Medical University Hospital, Taichung 408, Taiwan;

3Ph.D. Program in Translational Medicine, 4Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung 402, Taiwan;

5College of Medicine, China Medical University, Taichung 408, Taiwan

 

Purpose:

Both Sjogren’s syndrome and overactive bladder(OAB) are more prevalent in female. Previous studies have shown that patients with Sjogren's syndrome have a higher risk of developing OAB. However, the optimal management for these patients is unknown. Therefore, the purpose of this study is to evaluate the efficacy and safety profile of mirabegron, a beta-3 agonist compared to the anti-muscarinic agent in treating overactive bladder symptoms of patients with Sjogren’s syndrome.

 

Materials and Methods:

This is a prospective, randomized controlled trial. 55 Sjogren’s syndrome patients with Overactive Bladder Symptom Score (OABSS)≥4 were enrolled in this study. The included patients were randomized into two groups: beta-3 agonist and anti-muscarinic agent group. The primary outcome is the change in OABSS and EULAR Sjogren's Syndrome Patient Reported Index (ESSPRI). The secondary outcomes include the change in IPSS, bladder capacity, postvoid residual volume, voiding velocity, Patient Perception of Bladder Condition (PPBC). Secondary analysis of individual components of OABSS, IPSS, seropositive, and negative Sjogren syndrome was done. The statistical analysis was done using IBM SPSS v25.

 

Results: The median age was 64(34-85) years old. There were 55 patients enrolled in the study, with 28 randomized to the mirabegron arm and 27 to the solifenacin arm. All of the included patients were female. The change of OABSS in the mirabegron arm and solifenacin arm is comparable. The total OABSS of the mirabegron arm at the first visit, 1week, 1month, and 3 months is 6.8, 4.5, 4.6, 4 while the OABSS of the solifenacin arm is 7.5, 5.4, 4.4, 2.4. The change of ESSPRI is -5.1 in the mirabegron arm and 1.2 in the solifenacin arm. Four patients(15%) of the solifenacin arm chose to crossover to the mirabegron arm because of intolerance of the side effect, mainly dry mouth and constipation. There was no patient in the mirabegron arm who chose to crossover to solifenacin.

 

Conclusion:  Mirabegron and solifenacin are both effective in managing the OAB symptoms of Sjogren’s syndrome. Solifenacin has a higher rate of intolerance compared to mirabegron, suggesting that mirabegron might be a more suitable choice for Sjogren's syndrome patients with OAB symptoms.

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    2022-06-07 11:13:28
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