膀胱過動症病人以Mirabegron (25mg)治療效果實際經驗
沈元琦、莊燿吉
高雄長庚紀念醫院泌尿科
Mirabegron (25mg) in patients with overactive bladder is effective and safe in real life practice
Yuan Chi Shen、Yao Chi Chuang
 
Purpose: Antimuscarinic (AM) agents are the mainstay of oral pharmacotherapy for overactive bladder (OAB), however, AM-associated adverse events or insufficient efficacy limited its clinical persistence. Mirabegron is a potent and selective β3-adrenoceptor agonist that could exert an inhibitory effect on bladder afferent and OAB symptoms. We conducted a postmarketing study to evaluate the efficacy and safety of Mirabegron(25mg) in patients with OAB.
Materials and Methods: The study was a retrospective consecutive cohort of 73 OAB patients (50 male and 23 female) treated with Mirabegron 25 mg. The outcomes were initially assessed and re-evaluated 4 weeks later using the uroflow study, post-void residual urine and questionnaire with International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS), Urgency Severity Score (USS) and Quality of Life (QOL)
Results: At 4 weeks post-treatment, Mirabegron usage was associated with a statistically significant decrease in OABSS, USS, IPSS-V and IPSS-S (Shown in Table.1). Furthermore, the nocturia scoring in IPSS questionnaire was also decrease from 2.8± 1.7 to 2.2 ± 1.3 (p=0.006). Table.2 showed no compromise of uroflow rate and no increase of post-void residual urine. Three out of 21 patients (14%) with hypertension was found with elevated blood pressure, and discontinue Mirabegron treatment after one month of initial treatment.
 
Table.1 Baseline and post-treatment symptom score
 
 
Mean±SE
P value
IPSS-Voiding – 0 week
7.4± 1.1
.004
IPSS-Voiding– 4week
4.8±0.9
 
IPSS-Storage – 0 week
9.0±0.6
.003
IPSS-Storage – 4week
7.0±0.5
 
IPSS-Total –0week
16.3±1.4
.000
IPSS-Total –4week
11.9±1.2
 
OABSS–0week
OABSS – 4week
9.3±0.7
.006
7.2±0.6
 
USS – 0week
2.2±0.2
.005
USS –4week
1.4±0.1
 
Nocturia –0week
2.8±0.3
.006
Nocturia – 4week
2.2±0.3
 
QOL – 0week
4.3±0.2
.002
QOL – 4week
3.1±0.3
 
 
Table.2 Uroflow study and post-void residual urine
 
Mean±SE
P value
Uroflow voiding volume – 0week
206.3±25.6
.270
Uroflow voiding volume – 4week
248.6±35.2
 
Qmax – 0week
11.0±1.9
.170
Qmax – 4week
13.5±1.5
 
Post-void residual – 0week
42.8±7.5
.127
Post-void residual – 4week
26.3±5.3
 
 
Conclusion: This post-marketing surveillance study confirms that Mirabegron(25mg) improves clinical outcomes in patients with OAB and the adverse  effects was low.
論文分類:  2  (填入編號,分類說明請參閱投稿須知第6點:1腫瘤、2下泌尿道症狀(LUTS) 、3結石、4腹腔鏡、5男性學、6婦女泌尿及尿路動態、7泌尿道感染及外生殖器官的疾病、8小兒泌尿、9腎臟移植、10其他)
文章屬性:■臨床研究 □基礎研究 □病例報告
發表方式:□一般論文(口頭報告)  □討論式海報展示  ■非討論式海報展示(可複選■)
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