University of Alberta, Edmonton, Alberta, Canada.
Neurourol Urodyn. 2014 Jan;33(1):106-14. doi: 10.1002/nau.22383. Epub 2013 Mar 4.
To assess the long-term safety, tolerability, and efficacy of flexible-dose fesoterodine in elderly patients with OAB.
Patients aged ≥65 years who completed a 12-week, randomized, double-blind, placebo-controlled trial were eligible for the 12-week, open-label (OL) extension phase. Patients who received double-blind placebo started on fesoterodine 4 mg and could increase to 8 mg after 4 or 8 weeks of OL treatment, while fesoterodine-treated patients continued on their double-blind dose; only one dose escalation or de-escalation was permitted. Discontinuations and adverse events (AEs) were monitored, and patients completed 3-day bladder diaries and patient-reported outcomes at the beginning and end of the 12-week OL phase.
Six hundred fifty-four patients entered the 12-week OL extension (mean age 72 years; 52% women). AEs were reported by 30.7% and 48.1% of patients who had received double-blind fesoterodine and placebo, respectively; 1.9% and 9.4%, discontinued due to AEs, respectively. Patients who received double-blind fesoterodine maintained their efficacy response. After 12 weeks of OL treatment, efficacy outcomes in patients who received double-blind placebo were similar to those who had received double-blind fesoterodine. On average, the efficacy response was maintained for the duration of the study.
Fesoterodine was well tolerated and improvements in OAB symptoms and quality of life measures were not diminished with longer-term treatment of patients aged ≥65 years.
评估在 OAB 老年患者中使用剂量灵活的非索罗定的长期安全性、耐受性和疗效。
完成了 12 周随机、双盲、安慰剂对照试验的年龄≥65 岁的患者有资格参加 12 周的开放标签(OL)扩展阶段。接受双盲安慰剂的患者开始服用非索罗定 4mg,并在 OL 治疗的 4 或 8 周后可增加至 8mg,而接受非索罗定治疗的患者继续服用双盲剂量;只允许一次剂量增加或减少。监测停药和不良事件(AE),患者在 12 周 OL 阶段开始和结束时完成 3 天膀胱日记和患者报告的结局。
654 名患者进入 12 周 OL 扩展期(平均年龄 72 岁;52%为女性)。分别有 30.7%和 48.1%接受双盲非索罗定和安慰剂治疗的患者报告了 AE;分别有 1.9%和 9.4%因 AE 而停药。接受双盲非索罗定治疗的患者保持了疗效反应。在 OL 治疗 12 周后,接受双盲安慰剂治疗的患者的疗效结果与接受双盲非索罗定治疗的患者相似。平均而言,疗效反应在研究期间得以维持。
非索罗定耐受性良好,并且在≥65 岁患者的长期治疗中,OAB 症状和生活质量测量的改善没有减弱。