Michel Martin C, Schumacher Helmut, Mehlburger Ludwig, de la Rosette Jean J M C H
Department of Pharmacology, Johannes Gutenberg University, Mainz, Germany.
Consultant, Ingelheim, Germany.
Front Pharmacol. 2020 Jun 4;11:816. doi: 10.3389/fphar.2020.00816. eCollection 2020.
Nocturia impairs quality of life (QoL). We have performed a non-interventional study in which men with lower urinary tract symptoms (LUTS) were treated for at least 3 months with tamsulosin oral controlled absorption system (0.4 mg q.d.). Other than observing efficacy and tolerability of this drug formulation, the study was designed to explore the relative roles of number of nocturia episodes and of non-urological causes of nocturia on nocturia-related QoL at baseline and treatment-associated changes thereof. The study enrolled 5775 men seeking treatment of their LUTS. Tamsulosin improved LUTS, e.g. International Prostate Symptom Score from 19.5 ± 5.9 to 10.1 ± 4.9 (means ± SD). This was associated by clinically meaningful improvements in the Nocturia QoL score (from 45 ± 19 to 73 ± 17 points) and other QoL scores. Number of nocturnal voids was the key driver of all QoL scores at baseline; change of number of nocturia episodes that of improvement of all QoL scores upon treatment. In contrast, non-urological causes of nocturia such as heart failure, diabetes, sleep apnea, fluid or alcohol intake or use of diuretics or hypnotics had only small if any effects on baseline QoL or treatment-associated improvements thereof. The observed effects of non-urological causes on QoL apparently were largely driven by their effect on number of nocturnal voids. These data further support the idea that improvement of nocturia may be an important treatment goal in male LUTS.
夜尿症会损害生活质量(QoL)。我们进行了一项非干预性研究,对患有下尿路症状(LUTS)的男性使用坦索罗辛口服控释系统(每日0.4毫克)进行了至少3个月的治疗。除了观察这种药物制剂的疗效和耐受性外,该研究旨在探讨夜尿症发作次数和夜尿症非泌尿系统病因对基线时与夜尿症相关的生活质量及其治疗相关变化的相对作用。该研究招募了5775名寻求治疗LUTS的男性。坦索罗辛改善了LUTS,例如国际前列腺症状评分从19.5±5.9降至10.1±4.9(均值±标准差)。这伴随着夜尿症生活质量评分(从45±19分提高到73±17分)和其他生活质量评分在临床上有意义的改善。夜间排尿次数是基线时所有生活质量评分的关键驱动因素;夜尿症发作次数的变化则是治疗后所有生活质量评分改善的驱动因素。相比之下,夜尿症的非泌尿系统病因,如心力衰竭、糖尿病、睡眠呼吸暂停、液体或酒精摄入或使用利尿剂或催眠药,对基线生活质量或其治疗相关改善的影响即使有也很小。非泌尿系统病因对生活质量的观察到的影响显然在很大程度上是由它们对夜间排尿次数的影响驱动的。这些数据进一步支持了这样一种观点,即改善夜尿症可能是男性LUTS的一个重要治疗目标。