Lee Cheng-Ling, Ong Hueih-Ling, Kuo Hann-Chorng
Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan.
Tzu Chi Med J. 2019 Apr 2;32(1):30-35. doi: 10.4103/tcmj.tcmj_226_18. eCollection 2020 Jan-Mar.
The objective of this study was to evaluate the efficacy of mirabegron 25 mg daily in patients with nocturia-predominant hypersensitive bladder (HSB).
This study prospectively investigated 219 consecutive patients with nocturia-predominant HSB and treated with mirabegron 25 mg daily from July 2015 to 2016. Patient with nocturia episode decreased by ≥1/night after treatment was considered successful. The subjective symptom score, such as International Prostate Symptom Score (IPSS), Quality of life index, Overactive Bladder Symptom Score (OABSS), Urgency Severity Scale, patient perception of bladder condition (PPBC), and nocturia episodes per night, was assessed before and 1 month after mirabegron treatment and between successful and failed groups.
A total of 219 patients, including 51 women and 168 men, were enrolled. The mean age of the population was 72.3 ± 11.0 years. Totally, 58 (26.5%) of the patients had improvement in nocturia at 1 month after treatment. Among them, 14 (27.5%) women and 44 (26.2%) men had improvement in nocturia episodes after treatment ( = 0.858). Compared the clinical data between successful and failed group, the baseline symptom scores were more severe in successful group, including IPSS-storage subscore (4.84 ± 2.09 vs. 4.11 ± 2.19, = 0.031), OABSS (3.21 ± 0.67 vs. 2.91 ± 1.00, = 0.037), and nocturia episodes (3.81 ± 0.95 vs. 3.095 ± 1.32, = 0.000). Multivariate analysis revealed only a higher nocturia episodes ( = 0.046) predict a successful treatment result. Mirabegron 25 mg daily significantly improved PPBC score along the 3 months' follow-up ( < 0.05), and postvoid residual volume did not increase after mirabegron treatment in overall patients.
Mirabegron 25 mg daily treatment showed a limited therapeutic effect on nocturia-predominant HSB patients. The patients with higher OAB symptoms predict a successful result.
本研究旨在评估每日服用25毫克米拉贝隆对以夜尿为主的膀胱过度敏感（HSB）患者的疗效。
本研究前瞻性调查了2015年7月至2016年期间连续219例以夜尿为主的HSB患者，这些患者每日接受25毫克米拉贝隆治疗。治疗后夜尿发作次数每晚减少≥1次的患者被视为治疗成功。在米拉贝隆治疗前、治疗1个月后以及成功组和失败组之间，评估主观症状评分，如国际前列腺症状评分（IPSS）、生活质量指数、膀胱过度活动症症状评分（OABSS）、尿急严重程度量表、患者对膀胱状况的感知（PPBC）以及每晚的夜尿发作次数。
共纳入219例患者，其中女性51例，男性168例。人群的平均年龄为72.3±11.0岁。治疗1个月后，共有58例（26.5%）患者的夜尿症状有所改善。其中，14例（27.5%）女性和44例（26.2%）男性治疗后夜尿发作次数有所改善（P = 0.858）。比较成功组和失败组的临床数据，成功组的基线症状评分更严重，包括IPSS储尿亚评分（4.84±2.09对4.11±2.19，P = 0.031）、OABSS（3.21±0.67对2.91±1.00，P = 0.037）和夜尿发作次数（3.81±0.95对3.095±1.32，P = 0.000）。多因素分析显示，只有较高的夜尿发作次数（P = 0.046）可预测治疗成功结果。每日25毫克米拉贝隆在3个月的随访期间显著改善了PPBC评分（P < 0.05），总体患者米拉贝隆治疗后残余尿量未增加。
每日25毫克米拉贝隆治疗对以夜尿为主的HSB患者显示出有限的治疗效果。OAB症状较高的患者预测治疗结果成功。
