King's College Hospital, London, UK.
Guy's and St Thomas' Hospital, London, UK.
Neurourol Urodyn. 2018 Jan;37(1):394-406. doi: 10.1002/nau.23315. Epub 2017 Jul 13.
To evaluate patient-reported outcomes (PROs) of combinations of solifenacin and mirabegron compared with solifenacin and mirabegron monotherapy and with placebo in patients with overactive bladder (OAB) from the SYNERGY trial.
Following a 4-week placebo run-in, period patients (≥18 years) with OAB were randomized 2:2:1:1:1:1 to receive solifenacin 5 mg + mirabegron 25 mg (combination 5 + 25 mg), solifenacin 5 mg + mirabegron 50 mg, (combination 5 + 50 mg), solifenacin 5 mg, mirabegron 25 mg, mirabegron 50 mg or placebo for 12 weeks, followed by a 2-week washout period. At each visit, PROs related to quality of life, symptom bother, and treatment satisfaction were assessed, including OAB-q Symptom Bother score, health-related quality of life (HRQOL) Total score, treatment satisfaction-visual analogue scale (TS-VAS), and patient perception of bladder condition (PPBC) questionnaires.
Overall, 3527 patients were randomized into the study, with 3494 receiving double-blind treatment. At end of treatment (EoT), both combination groups showed greater improvements in OAB-q Symptom Bother score compared with the monotherapy groups (nominal P < 0.001). Statistically significant improvements in HRQOL Total scores were observed in the combination groups versus monotherapy groups (P ≤ 0.002). For both combination groups, the OAB-q Symptom Bother score responder rates at EoT were statistically significantly higher versus mirabegron monotherapy (P < 0.05). The mean adjusted changes from baseline to EoT for PPBC were greater in the combination groups compared with monotherapy groups.
PROs showed that combination therapy provided clear improvements and an additive effect for many HRQOL parameters, including OAB-q Symptom Bother score, HRQOL Total score, and PPBC.
评估索利那新与米拉贝隆联合治疗与索利那新和米拉贝隆单药治疗以及安慰剂治疗膀胱过度活动症(OAB)患者的患者报告结局(PRO)。
在 4 周安慰剂导入期后,≥18 岁的 OAB 患者按 2:2:1:1:1:1 的比例随机分为索利那新 5mg+米拉贝隆 25mg(联合 5+25mg)、索利那新 5mg+米拉贝隆 50mg(联合 5+50mg)、索利那新 5mg、米拉贝隆 25mg、米拉贝隆 50mg 或安慰剂组,治疗 12 周,随后进行 2 周洗脱期。每次就诊时,评估与生活质量、症状困扰和治疗满意度相关的 PRO,包括 OAB-q 症状困扰评分、健康相关生活质量(HRQOL)总分、治疗满意度视觉模拟量表(TS-VAS)和患者对膀胱状况的感知(PPBC)问卷。
共有 3527 例患者被随机分组进入研究,3494 例患者接受了双盲治疗。治疗结束时(EoT),与单药治疗组相比,两组联合治疗组的 OAB-q 症状困扰评分均有更大改善(名义 P<0.001)。与单药治疗组相比,联合治疗组的 HRQOL 总分有统计学意义的改善(P≤0.002)。对于两组联合治疗组,EoT 时 OAB-q 症状困扰评分的应答率均显著高于米拉贝隆单药治疗组(P<0.05)。与单药治疗组相比,联合治疗组从基线到 EoT 的平均调整后的 PPBC 变化更大。
PRO 结果表明,联合治疗为许多 HRQOL 参数(包括 OAB-q 症状困扰评分、HRQOL 总分和 PPBC)提供了明显的改善和累加效应。