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长期使用A型肉毒杆菌毒素治疗特发性膀胱过度活动症患者后,尿失禁得到持久改善且治疗反应呈阳性:3.5年研究的最终结果

Durable improvements in urinary incontinence and positive treatment response in patients with idiopathic overactive bladder syndrome following long-term onabotulinumtoxinA treatment: Final results of 3.5-year study.

作者信息

Chartier-Kastler E, Nitti V, De Ridder D, Sussman D, Sand P, Sievert K, Chapple C, Charmaine J, Magyar A, Radomski S

机构信息

Hôpital universitaire Pitié-Salpétrière, UPMC, Paris 6, Paris, France.

New York university, school of medicine, New-york, NY, United States.

出版信息

Prog Urol. 2015 Nov;25(13):739. doi: 10.1016/j.purol.2015.08.047.

DOI:10.1016/j.purol.2015.08.047
PMID:26544243
Abstract

OBJECTIVES

Here we present the final results from an extension study assessing long-term onabotulinumtoxinA treatment (3.5 years) in patients with idiopathic overactive bladder.

METHODS

Patients who completed either of 2 Phase III trials were eligible to enter a 3-year extension study in which they received multiple onabotulinumtoxinA (100 U) treatments. Data were analyzed for the overall population of patients who received 100 U in any treatment cycle (n=829) and within discrete subgroups of patients who received exactly 1 (n=105), 2 (n=118), 3 (n=117), 4 (n=83), 5 (n=46), or 6 (n=33) treatments of the 100 U dose throughout the study (n=502).

RESULTS

Of the 829 patients enrolled, 51.7 % completed the study. Discontinuations due to AEs/lack of efficacy were low (5.1/5.7 %); other reasons were not treatment-related. Mean reductions from baseline in urinary incontinence (UI) episodes/day (week 12; co-primary endpoint) were consistent among discrete subgroups who received 1 (-3.1), 2 (-2.9, -3.2), 3 (-4.1 to -4.5), 4 (-3.4 to -3.8), 5 (-3.0 to -3.6), or 6 (-3.1 to -4.1) treatments. A consistently high proportion of patients reported improvement/great improvement on the Treatment Benefit Scale (week 12; co-primary endpoint) in the discrete subgroups across all treatments (70.0-93.5 %). Median time to request retreatment was ≤6 months for 34.2 %, >6-≤12 months for 37.2 %, and >12 months for 28.5 % of patients. Most common AE was UTI, with no changes in safety profile over time.

CONCLUSION

Long-term onabotulinumtoxinA treatment resulted in consistent reductions in UI and high proportions of patients reporting improvement after each treatment, with no new safety findings.

摘要

目的

在此我们展示一项扩展研究的最终结果,该研究评估了肉毒杆菌毒素A(onabotulinumtoxinA)对特发性膀胱过度活动症患者的长期治疗效果(3.5年)。

方法

完成两项III期试验中任意一项的患者有资格进入一项为期3年的扩展研究,在此期间他们接受多次肉毒杆菌毒素A(100单位)治疗。对在任何治疗周期接受100单位治疗的所有患者(n = 829)以及在整个研究中恰好接受1次(n = 105)、2次(n = 118)、3次(n = 117)、4次(n = 83)、5次(n = 46)或6次(n = 33)100单位剂量治疗的离散亚组患者(n = 502)的数据进行了分析。

结果

在829名入组患者中,51.7%完成了研究。因不良事件/缺乏疗效导致的停药率较低(分别为5.1%/5.7%);其他原因与治疗无关。在接受1次(-3.1)、2次(-2.9,-3.2)、3次(-4.1至-4.5)、4次(-3.4至-3.8)、5次(-3.0至-3.6)或6次(-3.1至-4.1)治疗的离散亚组中,尿失禁(UI)发作次数/天从基线的平均减少量(第12周;共同主要终点)是一致的。在所有治疗的离散亚组中,持续有高比例的患者在治疗获益量表(第12周;共同主要终点)上报告有改善/显著改善(70.0 - 93.5%)。34.2%的患者再次治疗请求的中位时间≤6个月,37.2%的患者>6至≤12个月,28.5%的患者>12个月。最常见的不良事件是尿路感染,随着时间推移安全性概况无变化。

结论

长期肉毒杆菌毒素A治疗导致尿失禁持续减少,且每次治疗后报告有改善的患者比例较高,未发现新的安全性问题。

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