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米拉贝隆对膀胱过度活动症患者相关结局的影响:使用三项随机III期试验的汇总数据进行事后相关性分析和应答者分析的结果

The effect of mirabegron on patient-related outcomes in patients with overactive bladder: the results of post hoc correlation and responder analyses using pooled data from three randomized Phase III trials.

作者信息

Castro-Diaz D, Chapple C R, Hakimi Z, Blauwet M B, Delgado-Herrera L, Lau W, Mujais S

机构信息

Department of Urology, University Hospital of the Canary Islands, Ofra s/n. La Cuesta-38320-La Laguna, Santa Cruz de Tenerife, Spain,

出版信息

Qual Life Res. 2015 Jul;24(7):1719-27. doi: 10.1007/s11136-014-0904-4. Epub 2015 Feb 17.

Abstract

PURPOSE

To understand how improvements in the symptoms of overactive bladder (OAB) seen with the β3-adrenoceptor agonist mirabegron 50 mg, correlate with patient experience as measured by validated and standard patient-reported outcomes (PROs), and to identify whether there is overall directional consistency in the responsiveness of PROs to treatment effect.

METHODS

In a post hoc analysis of pooled data from three randomized, double-blind, placebo-controlled, 12-week Phase III trials of mirabegron 50 mg once daily, responder rates for incontinence frequency (≥50 % reduction in incontinence episodes/24 h from baseline to final visit), micturition frequency (≤8 micturitions/24 h at final visit), and PROs [minimally important differences in patient perception of bladder condition (PPBC) and subsets of the overactive bladder questionnaire (OAB-q) measuring total health-related quality of life (HRQoL), and symptom bother] were evaluated individually and in combination.

RESULTS

Mirabegron 50 mg demonstrated greater improvement from baseline to final visit than placebo for each of the responder analyses, whether for individual objective and subjective outcomes or combinations thereof. These improvements versus placebo were statistically significant for all double and triple responder analyses and for all single responder analyses except PPBC. PRO measurements showed directional consistency and significant correlations, and there were also significant correlations between objective and subjective measures of efficacy.

CONCLUSIONS

The improvements in objective measures seen with mirabegron 50 mg translate into a meaningful clinical benefit as evident by the directional consistency seen in HRQoL measures of benefit.

摘要

目的

了解每日一次服用50毫克β3肾上腺素能受体激动剂米拉贝隆后,膀胱过度活动症(OAB)症状的改善情况与通过经过验证的标准患者报告结局(PRO)所衡量的患者体验之间的相关性,并确定PRO对治疗效果的反应在总体方向上是否一致。

方法

在一项事后分析中,汇总了三项随机、双盲、安慰剂对照的III期试验的数据,这三项试验中患者每日一次服用50毫克米拉贝隆,为期12周。分别评估并综合评估了失禁频率(从基线到末次访视失禁发作次数/24小时减少≥50%)、排尿频率(末次访视时≤8次排尿/24小时)以及PRO[患者对膀胱状况感知(PPBC)的最小重要差异和膀胱过度活动症问卷(OAB-q)中测量与健康相关的总体生活质量(HRQoL)及症状困扰的子集]的应答率。

结果

无论是对于单个客观和主观结局还是其组合,在每次应答者分析中,50毫克米拉贝隆从基线到末次访视的改善均大于安慰剂。与安慰剂相比,所有双重和三重应答者分析以及除PPBC外的所有单应答者分析中,这些改善均具有统计学意义。PRO测量显示出方向一致性和显著相关性,并且疗效的客观和主观测量之间也存在显著相关性。

结论

50毫克米拉贝隆在客观测量方面的改善转化为有意义的临床益处,这在HRQoL益处测量中所显示的方向一致性中很明显。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6c1/4483243/6e7ac00472e1/11136_2014_904_Fig1_HTML.jpg

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