Kang Tae Wook, Chung Hyun Chul
Department of Urology, Yonsei University Wonju College of Medicine, Wonju, South Korea.
Department of Urology, Yonsei University Wonju College of Medicine, 20Ilsan-ro, Wonju-si, Kangwon-do, 220-701, South Korea.
Ther Adv Urol. 2020 Dec 18;12:1756287220974130. doi: 10.1177/1756287220974130. eCollection 2020 Jan-Dec.
The aim of this study was to evaluate the change in lower urinary tract symptoms and quality of life (QoL) after combination therapy of solifenacin and mirabegron in patients with benign prostatic hyperplasia presenting with persistent storage symptoms after treatment with tamsulosin.
MATERIAL & METHODS: We evaluated the International Prostatic Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS), prostate-specific antigen, prostate volume, peak flow rate (Qmax), and post-voided residual volume (PVR) before and after treatment. Patients showing baseline OABSS ⩾3 were included and treated with tamsulosin 0.2 mg as an initial drug for 1 month. After 1 month, add-on treatment with solifenacin 5 mg or mirabegron 50 mg was provided to patients who did not show improvement in OABSS with tamsulosin 0.2 mg. After 2 months, we evaluated changes in OABSS, IPSS, Qmax, and PVR.
After combination therapy for 2 months, there were no significant differences between patients receiving add-on treatment with solifenacin and those receiving mirabegron. However, the IPSS QoL score improved in patients treated with mirabegron and tamsulosin more than in those treated with solifenacin and tamsulosin ( < 0.05).
A combination of tamsulosin and mirabegron might improve the QoL of patients presenting with persistent storage symptoms after tamsulosin monotherapy. Better QoL due to mirabegron compared with solifenacin could be associated with fewer adverse effects, such as dry mouth and constipation.
本研究旨在评估坦索罗辛治疗后仍有持续性储尿期症状的良性前列腺增生患者,在接受索利那新与米拉贝隆联合治疗后下尿路症状及生活质量(QoL)的变化。
我们评估了治疗前后的国际前列腺症状评分(IPSS)、膀胱过度活动症症状评分(OABSS)、前列腺特异性抗原、前列腺体积、最大尿流率(Qmax)和残余尿量(PVR)。纳入基线OABSS⩾3的患者,以0.2mg坦索罗辛作为初始药物治疗1个月。1个月后,对于使用0.2mg坦索罗辛治疗后OABSS未改善的患者,加用5mg索利那新或50mg米拉贝隆进行治疗。2个月后,我们评估了OABSS、IPSS、Qmax和PVR的变化。
联合治疗2个月后,接受索利那新加用治疗的患者与接受米拉贝隆治疗的患者之间无显著差异。然而,米拉贝隆与坦索罗辛联合治疗的患者IPSS生活质量评分的改善程度高于索利那新与坦索罗辛联合治疗的患者(P<0.05)。
坦索罗辛与米拉贝隆联合使用可能改善坦索罗辛单药治疗后仍有持续性储尿期症状患者的生活质量。与索利那新相比,米拉贝隆所致生活质量改善更好可能与口干和便秘等不良反应较少有关。