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特发性或神经源性膀胱过度活动症患者使用抗毒蕈碱药物治疗的实际持续率:一项关于索利那新的前瞻性队列研究

Real life persistence rate with antimuscarinic treatment in patients with idiopathic or neurogenic overactive bladder: a prospective cohort study with solifenacin.

作者信息

Tijnagel Marloes J, Scheepe Jeroen R, Blok Bertil F M

机构信息

Department of Urology, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.

出版信息

BMC Urol. 2017 Apr 13;17(1):30. doi: 10.1186/s12894-017-0216-4.

DOI:10.1186/s12894-017-0216-4
PMID:28403849
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5390358/
Abstract

BACKGROUND

Several studies have shown that the antimuscarinic treatment of overactive bladder is characterized by low long-term persistence rates. We have investigated the persistence of solifenacin in real life by means of telephonic interviews in a prospective cohort. We included both patients with idiopathic overactive bladder as well as neurogenic overactive bladder.

METHODS

From June 2009 until July 2012 patients with idiopathic or neurogenic overactive bladder who were newly prescribed solifenacin were included. In total 123 subjects were followed prospectively during one year by means of four telephonic interviews, which included questions about medication use and adverse events.

RESULTS

After one year 40% of all patients included was still using solifenacin, 50% discontinued and 10% was lost to follow-up. In the neurogenic group 58% was still using solifenacin versus 32% in the idiopathic group after one year (p < 0,05). The main reasons to stop solifenacin were lack of efficacy, side effects and a combination of both.

CONCLUSIONS

This prospective cohort study showed a real life continuation rate of 40% after 12 months. This continuation rate is higher than found in most other studies. The use of regular telephonic evaluation might have improved medication persistence. The findings of this study also suggest that patients with neurogenic overactive bladder have a better persistence with this method of evaluation compared to patients with idiopathic overactive bladder.

TRIAL REGISTRATION

This study was retrospectively registered on march 17, 2017 at the ISRCTN registry with study ID ISRCTN13129226 .

摘要

背景

多项研究表明,抗毒蕈碱药物治疗膀胱过度活动症的特点是长期持续用药率较低。我们通过电话访谈对索利那新在实际生活中的持续用药情况进行了前瞻性队列研究。研究对象包括特发性膀胱过度活动症患者和神经源性膀胱过度活动症患者。

方法

纳入2009年6月至2012年7月新开具索利那新处方的特发性或神经源性膀胱过度活动症患者。通过四次电话访谈对123名受试者进行了为期一年的前瞻性随访,访谈内容包括用药情况和不良事件。

结果

一年后,所有纳入患者中有40%仍在使用索利那新,50%停药,10%失访。一年后,神经源性组中58%仍在使用索利那新,而特发性组为32%(p<0.05)。停用索利那新的主要原因是疗效不佳、副作用以及两者兼有。

结论

这项前瞻性队列研究显示,12个月后的实际持续用药率为40%。这一持续用药率高于大多数其他研究。定期电话评估可能提高了药物持续使用情况。本研究结果还表明,与特发性膀胱过度活动症患者相比,神经源性膀胱过度活动症患者采用这种评估方法的持续用药情况更好。

试验注册

本研究于2017年3月17日在ISRCTN注册中心进行回顾性注册,研究识别号为ISRCTN13129226。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e37c/5390358/6d91fc831849/12894_2017_216_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e37c/5390358/6d91fc831849/12894_2017_216_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e37c/5390358/6d91fc831849/12894_2017_216_Fig1_HTML.jpg

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