Gamble Tondalaya, Sand Peter
Evanston Continence Center, Division of Urogynecology, Department of Obstetrics and Gynecology, Evanston Northwestern Healthcare, Northwestern University, Feinberg School of Medicine, Evanston, Illinois.
Patient Prefer Adherence. 2008 Feb 2;2:349-56. doi: 10.2147/ppa.s3417.
Overactive bladder syndrome (OAB) is a constellation of distressing symptoms that significantly impair quality of life, sexual function, and work productivity, and imposes a significant economic burden to society. Pharmacological treatment with antimuscarinic agents, behavioral modification, bladder retraining, and/or pelvic floor exercises are often used alone or in combination as the mainstay treatment in the management of OAB. Oxybutynin has been used in the treatment of OAB for over 20 years with proven efficacy and is often the comparator in drug treatment trials. Oral formulations of oxybutynin have proven efficacy, but not without significant antimuscarinic effects, which reduce patient persistence with medical treatment. Low levels of patient persistence with oral formulations of oxybutynin provided an impetus for the development of a transdermal oxybutynin delivery system. The oxybutynin transdermal formulation has been found to have side effects similar to that of a placebo in randomized controlled trials while providing excellent efficacy. Patient persistence with therapy, improved quality of life, sexual function and interpersonal relationships have been observed with use of the transdermal oxybutynin delivery system. Its twice weekly dosing, low side effect profile, and high efficacy have made it a good choice for initial treatment of overactive bladder syndrome.
膀胱过度活动症(OAB)是一组令人苦恼的症状,会显著损害生活质量、性功能和工作效率,并给社会带来巨大的经济负担。抗毒蕈碱药物的药物治疗、行为矫正、膀胱再训练和/或盆底肌锻炼通常单独使用或联合使用,作为膀胱过度活动症管理的主要治疗方法。奥昔布宁已用于治疗膀胱过度活动症20多年,疗效已得到证实,并且常常是药物治疗试验中的对照药物。奥昔布宁的口服制剂疗效已得到证实,但并非没有明显的抗毒蕈碱作用,这降低了患者坚持药物治疗的意愿。奥昔布宁口服制剂的患者坚持率较低,这推动了奥昔布宁透皮给药系统的研发。在随机对照试验中,已发现奥昔布宁透皮制剂的副作用与安慰剂相似,同时疗效极佳。使用奥昔布宁透皮给药系统可观察到患者坚持治疗的情况、生活质量、性功能和人际关系均得到改善。其每周给药两次、低副作用和高效能使其成为膀胱过度活动症初始治疗的良好选择。