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膀胱内给药在患有神经源性下尿路功能障碍的成人和儿童中安全且耐受性良好:首例人体试验。

Intravesical is safe and well tolerated in adults and children with neurogenic lower urinary tract dysfunction: first-in-human trial.

作者信息

Groah Suzanne L, Rounds Amanda K, Ljungberg Inger H, Sprague Bruce M, Frost Jamie K, Tractenberg Rochelle E

机构信息

MedStar National Rehabilitation Hospital, 102 Irving St, NW, Washington, DC 20010, USA.

MedStar National Rehabilitation Hospital, Washington, DC, USA.

出版信息

Ther Adv Urol. 2019 Oct 3;11:1756287219875594. doi: 10.1177/1756287219875594. eCollection 2019 Jan-Dec.

Abstract

BACKGROUND

Urinary symptoms are common for people with neurogenic lower urinary tract dysfunction (NLUTD). No nonprescription approach has been proven safe and effective for self-management of urinary symptoms. Our objective was to describe the safety and tolerability of (®) instilled intravesically for self-management of inflammatory urinary symptoms in adults and children with NLUTD due to spinal cord injury or disease (SCI/D) and who use intermittent catheterization (IC).

METHODS

A total of 103 individuals with SCI/D enrolled in an 18-month study consisting of three 6-month stages: baseline (weekly observation of urinary symptoms); intervention (self-instilled intravesical ® in response to more cloudy or foul-smelling urine); and washout (weekly observation of urinary symptoms). Urinary symptoms were assessed using the Urinary Symptom Questionnaire for people with neurogenic bladder using intermittent catheters (USQNB-IC). Safety was based on serious adverse events and adverse events (S/AEs) and trends in symptoms. Tolerability was defined as the independence of AE experience and willingness to use/pay for this intervention.

RESULTS

A total of 74 (77%) adults and 6 (86%) of children completed the study, of whom 64 instilled ® for a total of 357 instillations (range 1-41 per person). There were 59 S/AEs, 44% (26/59) of which were categorized as infectious genitourinary. There was no statistical relationship between S/AEs and use or dose of the intervention.

CONCLUSIONS

One or two doses of self-instilled intravesical ® in response to more cloudy or foul-smelling urine was safe and well tolerated among this sample of adults and children with SCI/D who have NLUTD and use IC.

摘要

背景

神经源性下尿路功能障碍(NLUTD)患者常出现泌尿系统症状。尚无非处方方法被证明对泌尿系统症状的自我管理安全有效。我们的目的是描述膀胱内灌注(®)用于脊髓损伤或疾病(SCI/D)所致NLUTD且采用间歇性导尿(IC)的成人和儿童炎症性泌尿系统症状自我管理的安全性和耐受性。

方法

共有103例SCI/D患者参加了一项为期18个月的研究,该研究包括三个6个月阶段:基线期(每周观察泌尿系统症状);干预期(出现尿液更浑浊或有异味时自行膀胱内灌注®);洗脱期(每周观察泌尿系统症状)。使用间歇性导尿管的神经源性膀胱患者泌尿系统症状问卷(USQNB-IC)评估泌尿系统症状。安全性基于严重不良事件和不良事件(S/AEs)以及症状趋势。耐受性定义为不良事件经历的独立性以及使用/支付该干预措施的意愿。

结果

共有74名(77%)成人和6名(86%)儿童完成了研究,其中64人进行了®灌注,共灌注357次(每人1 - 41次)。有59例S/AEs,其中44%(26/59)归类为泌尿生殖系统感染。S/AEs与干预措施的使用或剂量之间无统计学关系。

结论

对于患有NLUTD且采用IC的SCI/D成人和儿童样本,出现尿液更浑浊或有异味时自行膀胱内灌注一或两剂®是安全且耐受性良好的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d2f/6777056/530abe7e6ac8/10.1177_1756287219875594-fig1.jpg

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