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米拉贝隆在≥75岁膀胱过度活动症患者中的安全性和有效性:一项日本上市后研究的分析

Safety and effectiveness of mirabegron in patients with overactive bladder aged ≥75 years: Analysis of a Japanese post-marketing study.

作者信息

Yoshida Masaki, Nozawa Yumiko, Kato Daisuke, Tabuchi Hiromi, Kuroishi Kentarou

机构信息

Department of Urology, National Center for Geriatrics and Gerontology, Aichi, Japan.

Astellas Pharma Inc., Tokyo, Japan.

出版信息

Low Urin Tract Symptoms. 2019 Jan;11(1):30-38. doi: 10.1111/luts.12190. Epub 2017 Sep 12.

Abstract

OBJECTIVES

A 12-week post-marketing study was conducted to provide real-world data on Japanese patients with overactive bladder (OAB) initiating treatment with mirabegron. This post-hoc analysis focused on safety and effectiveness of mirabegron in patients aged ≥75 versus <75 years.

METHODS

Incidence of adverse drug reactions (ADR) was assessed following 12 weeks' mirabegron treatment. Overactive Bladder Symptom Score (OABSS) and International-Prostate Symptom Score Quality of Life (I-PSS QoL) were completed at baseline and at the end of treatment (EoT). A reduction of ≥3 points in total OABSS was defined as a minimal clinically important change (MCIC).

RESULTS

Of 9795 patients, a greater proportion aged ≥75 versus <75 years had a lower body mass index (BMI; BMI < 18.5: 4.2% vs 3.2%), longer OAB duration (≥3 years: 24.6% vs 20.3%) and more severe OAB symptoms (severe: 17.0% vs 11.2%). A significantly greater percentage of patients aged ≥75 versus <75 years had comorbidities (77.8% vs 66.0%) and used concomitant drugs (58.3% vs 48.7%; P < 0.001). Incidence of ADR was observed in 7.00% and 5.19% of patients aged ≥75 versus <75 years, respectively. At EoT, mirabegron treatment was reported 'effective' in 79.3% versus 82.1% of patients aged ≥75 versus <75 years, respectively. Mean total OABSS decreased significantly from baseline, and exceeded the MCIC in 61.0% and 65.9% of patients aged ≥75 and <75 years, respectively. Similar changes were observed for I-PSS QoL in both groups.

CONCLUSIONS

In a real-world clinical setting, mirabegron was well-tolerated and effective in patients aged ≥75 and <75 years.

摘要

目的

开展一项为期12周的上市后研究,以获取关于日本膀胱过度活动症(OAB)患者起始使用米拉贝隆治疗的真实世界数据。这项事后分析聚焦于米拉贝隆在75岁及以上与75岁以下患者中的安全性和有效性。

方法

在米拉贝隆治疗12周后评估药物不良反应(ADR)的发生率。在基线期和治疗结束时(EoT)完成膀胱过度活动症症状评分(OABSS)和国际前列腺症状评分生活质量(I-PSS QoL)。总OABSS降低≥3分被定义为最小临床重要变化(MCIC)。

结果

在9795例患者中,75岁及以上患者较75岁以下患者有更大比例的体重指数较低(BMI;BMI<18.5:4.2%对3.2%)、OAB病程更长(≥3年:24.6%对20.3%)以及OAB症状更严重(重度:17.0%对11.2%)。75岁及以上患者较75岁以下患者有合并症(77.8%对66.0%)和使用伴随药物(58.3%对48.7%;P<0.001)的比例显著更高。75岁及以上和75岁以下患者中ADR的发生率分别为7.00%和5.19%。在EoT时,分别有79.3%和82.1%的75岁及以上和75岁以下患者报告米拉贝隆治疗“有效”。总OABSS均值较基线期显著降低,且分别有61.0%和65.9%的75岁及以上和75岁以下患者达到了MCIC。两组I-PSS QoL也观察到类似变化。

结论

在真实世界临床环境中,米拉贝隆在75岁及以上和75岁以下患者中耐受性良好且有效。

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