Mirabegron對夜尿的療效

翁慧鈴、李政霖 、郭漢崇

花蓮慈濟醫院 泌尿部

Therapeutic Efficacy of Mirabegron 25 mg Monotherapy in Patients with Nocturia-Predominant Hypersensitive Bladder

Hueih Ling Ong, Cheng-Ling Lee, Hann-Chorng Kuo

Department of Urology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan

Purpose: To evaluate the efficacy of mirabegron 25 mg daily in patients with nocturia- predominant hypersensitive bladder.

Materials and Methods: This study prospectively investigated 239 consecutive patients with nocturia-predominant hypersensitive bladder treated with mirabegron 25 mg daily from July 2015 till July 2016. A decrease in nocturia episodes by ≥1/night after treatment was considered successful. The subjective International Prostate Symptom Score (IPSS), Quality of Life Index (QoL-I), Overactive Bladder Symptom Score (OABSS), Urgency Severity Scale (USS), Patient Perception of Bladder Condition (PPBC), and nocturia episodes per night were assessed before and 1 month after mirabegron treatment and compared between successful and failed groups.

Results: The study enrolled 239 patients (66 women and 173 men), with mean age 72.3±11.0 years. Improvement in nocturia episodes after treatment was observed in 16 (28.6%) women and 50 (27.3%) men (p=0.855). The baseline symptom scores were more severe in the successful group: IPSS-storage subscore (5.06±2.35 vs. 4.16±2.25, p=0.008), OABSS (3.34±1.39 vs. 2.95±1.08, p=0.022), and nocturia episodes (3.80±0.98 vs. 3.15±1.33, p=0.00). Multivariate analysis revealed that higher IPSS-S (p=0.003) and PPBC (p=0.035) scores and more nocturia episodes (p=0.001) predicted successful treatment. Mirabegron 25 mg daily significantly improved PPBC scores during 12 months of follow-up (p<0.05) and post-void residual volume did not increase.

Conclusions: Mirabegron 25 mg daily had limited therapeutic effect on nocturia-predominant hypersensitive bladder. Higher OAB symptom scores predicted a successful result