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托特罗定治疗伴有逼尿肌过度活动症状和疑似非梗阻性良性前列腺增生的男性患者的症状和生活质量反应亚组分析。

Symptomatic and quality of life response to tolterodine in subgroups of men with overactive bladder symptoms and presumed non-obstructive benign prostatic hyperplasia.

机构信息

Evangelisches Krankenhaus Oberhausen, Klinik für Urologie, Virchowstr. 20, 46047, Oberhausen, Germany.

出版信息

World J Urol. 2010 Jun;28(3):353-7. doi: 10.1007/s00345-009-0460-7. Epub 2009 Dec 10.

Abstract

OBJECTIVES

To investigate the symptomatic and quality of life (QoL) response to treatment with tolterodine extended release (ER) in subgroups of male patients with Overactive Bladder Syndrome (OAB) and LUTS suggestive of non-obstructive benign prostatic hyperplasia (BPH) according to age, symptom severity, diabetes mellitus status, and concomitant treatment for LUTS.

METHODS

Patients treated with tolterodine ER 4 mg/day for OAB symptoms, alone or added to unsuccessful alpha-blocker treatment of > or =6 weeks duration, and presumed non-obstructive BPH (Q (max) > or = 15 ml/s) were observed for 12 weeks in a non-interventional study. Patients completed the International Prostate Symptom Score (IPSS) and Overactive Bladder Questionnaire (OAB-q) at baseline and after 12 weeks.

RESULTS

52.4% of 741 patients were aged < or =65 years; 4, 64, and 32% had mild, moderate, and severe symptoms, respectively, according to IPSS; 14% had diabetes mellitus, and in 42% tolterodine was added to alpha blockers. In the various subgroups, mean IPSS total scores improved by 2.8-11.1 points, IPSS QoL scores by 1.8-2.4 points, and all OAB-q subscores by more than 14 points. Only IPSS and OAB-q baseline scores had a relevant impact on changes during treatment, benefits were greatest in patients with more severe symptoms and bother.

CONCLUSIONS

In men with symptoms of OAB and LUTS suggestive of non-obstructive BPH of all IPSS severity classes, aged < or =65 years or above, with or without concomitant diabetes or alpha-blockers, symptoms and QoL improved markedly during treatment with tolterodine ER.

摘要

目的

考察托特罗定缓释片(ER)治疗伴有逼尿肌过度活动症(OAB)和下尿路症状(LUTS)的男性患者的症状和生活质量(QoL)反应,这些患者的 LUTS 提示有非梗阻性良性前列腺增生(BPH),且根据年龄、症状严重程度、糖尿病状态和 LUTS 的伴随治疗进行了分组。

方法

在一项非干预性研究中,741 例单独使用托特罗定 ER 4mg/天治疗 OAB 症状或加用治疗时间>6 周的α受体阻滞剂治疗失败的 OAB 患者,和(或)伴 LUTS 且最大尿流率(Q(max)>=15ml/s)提示有非梗阻性 BPH 的患者,接受托特罗定 ER 治疗 12 周。患者在基线和治疗 12 周时完成国际前列腺症状评分(IPSS)和逼尿肌过度活动症问卷(OAB-q)。

结果

52.4%的 741 例患者年龄<或=65 岁;根据 IPSS,4%、64%和 32%的患者分别有轻度、中度和重度症状;14%的患者有糖尿病,42%的患者托特罗定加用了α受体阻滞剂。在各亚组中,平均 IPSS 总分改善了 2.8-11.1 分,IPSS 生活质量评分改善了 1.8-2.4 分,OAB-q 的所有亚评分都改善了>14 分。只有 IPSS 和 OAB-q 的基线评分与治疗期间的变化有相关影响,在症状更严重和困扰更严重的患者中获益最大。

结论

在所有 IPSS 严重程度级别、年龄<或=65 岁或>65 岁、伴有或不伴有糖尿病或α受体阻滞剂的伴有 OAB 和 LUTS 提示有非梗阻性 BPH 的男性患者中,托特罗定 ER 治疗可显著改善症状和生活质量。

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