Shin Jung Hyun, Choo Myung-Soo
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Low Urin Tract Symptoms. 2019 May;11(3):151-157. doi: 10.1111/luts.12253. Epub 2019 Jan 8.
To evaluate the effectiveness and persistence of mirabegron as a first-line treatment in patients with overactive bladder (OAB) in real-life practice.
We retrospectively analyzed patients with OAB who received mirabegron (50 mg) as a first-line treatment. According to treatment course, patients were divided into three groups, (a) mirabegron only (monotherapy group), (b) mirabegron and anticholinergics (add-on group), and (c) mirabegron replaced with another treatment (switch group). The patients' symptoms were documented with a voiding diary including an urgency scale and a patient perception of treatment benefit questionnaire (PPTB). Follow-up was at 4 weeks after initial treatment and then 2 months later, according to our routine protocol.
A total of 196 patients were included: 128 patients (65.3%) received monotherapy and 60 patients (30.6%) received add-on therapy. Eight patients discontinued mirabegron and switched to another treatment modality. The add-on group had more episodes of baseline urinary frequency, nocturia and urgency than the monotherapy group (P = 0.011, 0.001, and 0.006, respectively). In the monotherapy group, mean daily frequency, nocturia, urgency episodes, and urgency urinary incontinence were improved (P < 0.05) after mirabegron treatment. The persistence of mirabegron monotherapy was 68.0% at 3 months, 54.4% at 6 months, and 39.4% at 12 months. Treatment-naïve patients had better persistency than previously anticholinergics-treated patients.
Mirabegron is an effective first-line therapy for OAB, but has a persistence rate of 39.4% at 12 months. Patients with severe baseline OAB symptoms tended to require add-on therapy during follow-up.
评估米拉贝隆作为一线治疗药物在现实生活中对膀胱过度活动症（OAB）患者的有效性和持续性。
我们回顾性分析了接受米拉贝隆（50毫克）作为一线治疗的OAB患者。根据治疗疗程，患者被分为三组：（a）仅使用米拉贝隆（单药治疗组），（b）米拉贝隆与抗胆碱能药物联合使用（联合治疗组），以及（c）米拉贝隆被其他治疗替代（转换治疗组）。通过排尿日记记录患者症状，其中包括急迫性评分和患者对治疗益处的感知问卷（PPTB）。根据我们的常规方案，在初始治疗后4周进行随访，然后在2个月后再次随访。
共纳入196例患者：128例患者（65.3%）接受单药治疗，60例患者（30.6%）接受联合治疗。8例患者停用米拉贝隆并转换为其他治疗方式。联合治疗组的基线尿频、夜尿和尿急发作次数比单药治疗组更多（分别为P = 0.011、0.001和0.006）。在单药治疗组中，米拉贝隆治疗后平均每日排尿次数、夜尿、尿急发作次数和急迫性尿失禁均有所改善（P < 0.05）。米拉贝隆单药治疗的持续性在3个月时为68.0%，6个月时为54.4%，12个月时为39.4%。初治患者的持续性优于先前接受过抗胆碱能药物治疗的患者。
米拉贝隆是一种有效的OAB一线治疗药物，但12个月时的持续性率为39.4%。基线OAB症状严重的患者在随访期间往往需要联合治疗。
