Wang Chung-Cheng, Jiang Yung-Hong, Kuo Hann-Chorng
Department of Urology, En Chu Kong Hospital, College of Medicine, National Taiwan University, New Taipei, Taiwan.
Department of Biomedical Engineering, Chung Yuan Christian University, Taoyuan, Taiwan.
Low Urin Tract Symptoms. 2019 Apr;11(2):O180-O185. doi: 10.1111/luts.12252. Epub 2018 Dec 18.
This study investigated factors predicting the resumption of mirabegron following its discontinuation with successful treatment of overactive bladder (OAB).
In all, 374 OAB patients reporting an improvement in subjective symptoms after a minimum of 3 months treatment with mirabegron 25 mg, q.d., were screened. Those wanting to continue with the medication (n = 109) were excluded from the study. The remaining 265 patients discontinued mirabegron and their outcomes were evaluated at baseline (discontinuation) and 1, 3, 6, 9, and 12 months using the International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS), Urgency Severity Scale (USS), Patient's Perception of Bladder Condition (PPBC), and Global Response Assessment (GRA), as well as uroflowmetry and post-void residual (PVR).
After mirabegron discontinuation, 203 patients completed follow-up. The mean (±SD) duration from discontinuing medication to resumption of mirabegron was 2.25 ± 1.17 months (range 1-12 months). Compared with the 111 (54.7%) patients who did not resume mirabegron, the 92 (45.3%) patients who resumed mirabegron had a higher USS at time of discontinuation (1.18 ± 1.76 vs. 0.65 ± 1.33; P = 0.017). The USS was a strong predictor of mirabegron resumption (P = 0.02; odds ratio 1.315; 95% confidence interval 1.051-1.646).
Among OAB patients who were successfully treated with mirabegron for ≥3 months, nearly half requested resumption of mirabegron after discontinuation. A higher USS was found to predict retreatment after discontinuation of mirabegron in OAB patients.
本研究调查了在膀胱过度活动症(OAB)成功治疗后停用米拉贝隆后预测其恢复使用的因素。
总共筛选了374例接受25mg米拉贝隆每日一次至少3个月治疗后主观症状有所改善的OAB患者。那些希望继续用药的患者(n = 109)被排除在研究之外。其余265例患者停用米拉贝隆,并在基线(停药时)以及1、3、6、9和12个月时使用国际前列腺症状评分(IPSS)、膀胱过度活动症症状评分(OABSS)、尿急严重程度量表(USS)、患者对膀胱状况的感知(PPBC)和总体反应评估(GRA)以及尿流率和残余尿量(PVR)对其结果进行评估。
停用米拉贝隆后,203例患者完成了随访。从停药到恢复使用米拉贝隆的平均(±标准差)持续时间为2.25±1.17个月(范围1 - 12个月)。与111例(54.7%)未恢复使用米拉贝隆的患者相比,92例(45.3%)恢复使用米拉贝隆的患者在停药时的USS更高(1.18±1.76对0.65±1.33;P = 0.017)。USS是米拉贝隆恢复使用的有力预测指标(P = 0.02;比值比1.315;95%置信区间1.051 - 1.646)。
在接受米拉贝隆成功治疗≥3个月的OAB患者中,近一半在停药后要求恢复使用米拉贝隆。发现较高的USS可预测OAB患者停用米拉贝隆后的再次治疗。