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采用 Axonics 可充电骶神经调节系统治疗急迫性尿失禁的 ARTISAN-SNM 研究的两年结果。

Two-year outcomes of the ARTISAN-SNM study for the treatment of urinary urgency incontinence using the Axonics rechargeable sacral neuromodulation system.

机构信息

Southern Urogynecology, West Columbia, South Carolina, USA.

Adult & Pediatric Urology & Urogynecology, Omaha, Nebraska, USA.

出版信息

Neurourol Urodyn. 2021 Feb;40(2):714-721. doi: 10.1002/nau.24615. Epub 2021 Jan 28.

Abstract

AIMS

Sacral neuromodulation (SNM) is a guideline-recommended treatment with proven therapeutic benefit for urinary urgency incontinence (UUI) patients. The Axonics® System is the first Food and Drug Administration-approved rechargeable SNM system and is designed to deliver therapy for a minimum of 15 years. The ARTISAN-SNM study was designed to evaluate UUI participants treated with the Axonics System. Two-year follow-up results are presented.

METHODS

One hundred and twenty-nine UUI participants underwent implantation with the Axonics System. Therapeutic response rate, participant quality of life (QoL), and satisfaction were determined using 3-day voiding diaries, ICIQ-OABqol, and satisfaction questionnaires. Participants were considered responders if they had a 50% or greater reduction in UUI episodes post-treatment. As-treated and Completers analyses are presented.

RESULTS

At 2 years, 93% of the participants (n = 121 Completers at 2 years) were therapy responders, of which 82% achieved ≥ 75% reduction in UUI episodes and 37% were dry (100% reduction). Daily UUI episodes reduced from 5.6 ± 0.3 at baseline to 1.0 ± 0.2 at 2 years. Statistically significant improvements in ICIQ-OABqol were reported. All participants were able to recharge their device and 94% of participants reported that the recharging frequency and duration were acceptable. Participant demographics nor condition severity were correlated with clinical outcomes or recharging experience. No unanticipated or serious device-related adverse events occurred.

CONCLUSIONS

At 2 years, participants treated with the Axonics System demonstrated sustained safety and efficacy, high levels of satisfaction with therapy and recharging. Participant-related factors were not associated with efficacy or recharging outcomes, indicating the reported results are applicable to a diverse population.

摘要

目的

骶神经调节(SNM)是一种被指南推荐的治疗方法,对急迫性尿失禁(UUI)患者具有明确的治疗益处。Axonics®系统是首个获得美国食品和药物管理局批准的可充电 SNM 系统,旨在提供至少 15 年的治疗。ARTISAN-SNM 研究旨在评估接受 Axonics 系统治疗的 UUI 参与者。本文呈现了两年的随访结果。

方法

129 名 UUI 参与者接受了 Axonics 系统植入。使用 3 天排尿日记、ICIQ-OABqol 和满意度问卷评估治疗反应率、参与者生活质量(QoL)和满意度。如果患者治疗后 UUI 发作减少 50%或更多,则认为其为有反应者。本文呈现了按治疗情况和完成者分析的结果。

结果

在 2 年时,93%的参与者(n=121 名完成者在 2 年时)为治疗有反应者,其中 82%的参与者达到了 UUI 发作减少≥75%,37%的参与者达到了无尿失禁(100%减少)。每日 UUI 发作从基线时的 5.6±0.3 减少到 2 年时的 1.0±0.2。报告了 ICIQ-OABqol 的显著改善。所有参与者都能够对其设备进行充电,94%的参与者报告说充电频率和持续时间是可以接受的。参与者的人口统计学特征或疾病严重程度与临床结果或充电体验无关。未发生意外或严重的与设备相关的不良事件。

结论

在 2 年时,接受 Axonics 系统治疗的参与者表现出持续的安全性和疗效,对治疗和充电的满意度很高。与参与者相关的因素与疗效或充电结果无关,这表明报告的结果适用于不同人群。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9465/7986436/1be6a71ac23f/NAU-40-714-g004.jpg

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