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性别、年龄或生活方式因素会影响膀胱过度活动症患者对抗毒蕈碱治疗的反应吗?

Do gender, age or lifestyle factors affect responses to antimuscarinic treatment in overactive bladder patients?

机构信息

Praxisklinik Urologie Rhein-Ruhr, Mülheim, Germany.

出版信息

Int J Clin Pract. 2010 Aug;64(9):1287-93. doi: 10.1111/j.1742-1241.2010.02442.x. Epub 2010 May 24.

Abstract

AIMS

Gender, age, obesity, smoking and alcohol or caffeine intake have been shown or proposed to be risk factors for the prevalence and/or severity of the overactive bladder symptom complex (OAB) or related parameters. We have explored whether any of these factors affect the therapeutic response to a muscarinic receptor antagonist during routine clinical use.

METHODS

Data were analysed from 3766 OAB patients (77.1% woman, age 62.6 +/- 12.8 years) participating in an observational, open-label postmarketing surveillance study of the safety and efficacy of darifenacin. Multiple logistic regression models were applied to explore the effect of potential OAB risk factors on the darifenacin treatment-associated improvement of OAB symptoms, patient's subjective rating of bladder problems and global efficacy and tolerability.

RESULTS

Age and (less consistently) gender were statistically significantly correlated with efficacy parameters, but the extent of their impact was judged to be too small to be clinically relevant. Except for a very small effect of body mass index on urgency episode improvement, none of the lifestyle-associated factors had significant effects on the efficacy of darifenacin. Except for a very small age effect, none of the potential risk factors had significant effects on global tolerability.

DISCUSSION AND CONCLUSIONS

We conclude that the efficacy and tolerability of a muscarinic receptor antagonist, such as darifenacin is largely independent of potential OAB risk factors, such as gender, age, obesity, smoking and alcohol or caffeine intake.

摘要

目的

性别、年龄、肥胖、吸烟和饮酒或咖啡因摄入已被证明或被提议为膀胱过度活动症(OAB)症状复杂或相关参数的流行率和/或严重程度的危险因素。我们已经探讨了这些因素中的任何一个是否会影响在常规临床使用中对毒蕈碱受体拮抗剂的治疗反应。

方法

对 3766 名参与达非那新安全性和疗效观察性、开放性、上市后监测研究的 OAB 患者(77.1%为女性,年龄 62.6 ± 12.8 岁)的数据进行了分析。应用多因素逻辑回归模型探讨了 OAB 潜在危险因素对达非那新治疗 OAB 症状、患者对膀胱问题的主观评分、总体疗效和耐受性的改善的影响。

结果

年龄和(不太一致)性别与疗效参数呈统计学显著相关,但判断其影响程度太小,无临床意义。除了体重指数对尿急发作改善的很小影响外,生活方式相关因素对达非那新的疗效无显著影响。除了年龄的微小影响外,潜在的危险因素对总体耐受性无显著影响。

讨论与结论

我们的结论是,毒蕈碱受体拮抗剂(如达非那新)的疗效和耐受性在很大程度上独立于 OAB 的潜在危险因素,如性别、年龄、肥胖、吸烟和饮酒或咖啡因摄入。

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