Staskin David R, Dmochowski Roger R, Sand Peter K, Macdiarmid Scott A, Caramelli Kim E, Thomas Heather, Hoel Gary
Caritas-St. Elizabeth's Medical Center, Tufts University Medical Center, Boston, Massachusetts, USA.
J Urol. 2009 Apr;181(4):1764-72. doi: 10.1016/j.juro.2008.11.125. Epub 2009 Feb 23.
We assessed the efficacy and safety of oxybutynin chloride topical gel vs placebo in adults with overactive bladder.
Men and women 18 years or older with urge predominant urinary incontinence were enrolled in randomized, parallel group, double-blind, placebo controlled Study OG05009 done at 76 clinics in the United States. Eligible patients were assigned to receive 1 gm oxybutynin chloride topical gel (10% weight per weight ethanol based formulation of oxybutynin) or matching placebo once daily for 12 weeks. Efficacy was assessed using data from 3-day urinary diaries and the primary outcome was the change from baseline in the number of urge incontinence episodes. Safety was monitored through adverse event reporting. Efficacy results in the oxybutynin chloride topical gel and placebo groups were compared by ANCOVA with last observations carried forward.
A total of 789 randomized patients, including 704 women (89.2%), with a mean age of 59 years were assigned to treatment with oxybutynin chloride topical gel (389) or placebo (400). The mean number of urge incontinence episodes decreased significantly more in patients treated with oxybutynin chloride topical gel than in those given placebo (-3.0 vs -2.5 per day, p <0.0001). Mean urinary frequency decreased (-2.7 per day, p = 0.0017) and voided volume increased (21.0 ml, p = 0.0018) significantly more in the oxybutynin chloride group than in the placebo group (-2.0 per day and 3.8 ml, respectively). Treatment related dry mouth was more frequent in the oxybutynin chloride group than in the placebo group (27 of 389 patients or 6.9% vs 11 of 400 or 2.8%). Application site reactions were infrequently observed in the oxybutynin chloride and placebo groups (21 of 389 patients or 5.4% and 4 of 400 or 1.0%, respectively). No serious treatment related adverse events occurred.
Oxybutynin chloride topical gel was efficacious in improving overactive bladder symptoms and was well tolerated in adult patients.
我们评估了氯化奥昔布宁外用凝胶与安慰剂对膀胱过度活动症成年患者的疗效和安全性。
18岁及以上以尿急为主的尿失禁男性和女性患者参加了在美国76家诊所进行的随机、平行组、双盲、安慰剂对照的OG05009研究。符合条件的患者被分配接受1克氯化奥昔布宁外用凝胶(10%重量比的基于乙醇的奥昔布宁制剂)或匹配的安慰剂,每日一次,共12周。使用3天排尿日记的数据评估疗效,主要结局是尿急失禁发作次数相对于基线的变化。通过不良事件报告监测安全性。采用协方差分析并结转最后观察值,比较氯化奥昔布宁外用凝胶组和安慰剂组的疗效结果。
共有789例随机分组患者,其中包括704名女性(89.2%),平均年龄59岁,被分配接受氯化奥昔布宁外用凝胶治疗(389例)或安慰剂治疗(400例)。接受氯化奥昔布宁外用凝胶治疗的患者尿急失禁发作的平均次数比接受安慰剂治疗的患者显著减少更多(每天-3.0次对-2.5次,p<0.0001)。氯化奥昔布宁组的平均排尿频率降低(每天-2.7次,p = 0.0017)且排尿量增加(21.0毫升,p = 0.0018),均显著多于安慰剂组(分别为每天-2.0次和3.8毫升)。氯化奥昔布宁组与治疗相关的口干比安慰剂组更常见(389例患者中有27例,即6.9%,而400例中有11例,即2.8%)。在氯化奥昔布宁组和安慰剂组中很少观察到用药部位反应(分别为389例患者中有21例,即5.4%,400例中有4例,即1.0%)。未发生与治疗相关的严重不良事件。
氯化奥昔布宁外用凝胶在改善膀胱过度活动症症状方面有效,且成年患者耐受性良好。