Section of Urology, Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
Department of Urology, Medical University of South Carolina, Charleston, South Carolina, USA.
Low Urin Tract Symptoms. 2021 Oct;13(4):425-434. doi: 10.1111/luts.12382. Epub 2021 May 14.
This analysis from the PERSPECTIVE (a Prospective, Non-interventional Registry Study of Patients Initiating a Course of Drug Therapy for Overactive Bladder) study evaluated treatment persistence with mirabegron or antimuscarinics over a 12-month period.
Participants were adults diagnosed with overactive bladder (OAB) by their health care provider (HCP), who were initiating mirabegron or antimuscarinic treatment. The HCP made all treatment decisions, and patients were followed for 12 months with no mandatory scheduled visits. Information requests were sent to patients at baseline and months 1, 3, 6, and 12. Patients were nonpersistent if they switched, discontinued, or added OAB medications/therapies to their initial treatment. Reasons for discontinuation and switching patterns were investigated.
Overall, 1514 patients were included (613 mirabegron and 901 antimuscarinic initiators). Persistence rates decreased steadily over time in both groups. A low proportion of patients added or switched medication at each time point. Unadjusted Kaplan-Meier analysis showed similar persistence rates for both groups. When the data were adjusted for patient characteristics (age, sex, and OAB treatment status), mirabegron initiators had higher persistence rates. No significant differences were noted in unadjusted median time to end of persistence. However, end of treatment persistence by any cause was longer with mirabegron (median: 9.5 vs 6.7 months for antimuscarinics). HCPs stated that the most common reasons for nonpersistence were no symptomatic improvement and side effect aversion.
Treatment persistence was longer for mirabegron compared with antimuscarinic initiators after controlling for patient characteristics. End of treatment persistence by any cause was also longer with mirabegron.
本分析源自 PERSPECTIVE（一项前瞻性、非干预性、患者起始治疗药物治疗膀胱过度活动症的登记研究），评估了米拉贝隆或抗毒蕈碱药物在 12 个月期间的治疗持续性。
参与者为经医疗保健提供者（HCP）诊断为膀胱过度活动症（OAB）的成年人，他们正在开始米拉贝隆或抗毒蕈碱药物治疗。HCP 做出所有治疗决策，患者在 12 个月期间接受随访，无需进行强制性预约就诊。在基线和第 1、3、6 和 12 个月时向患者发送信息请求。如果患者换药、停药或在初始治疗中添加 OAB 药物/疗法，则被认为是不持续治疗。调查了停药和换药模式的原因。
总体而言，共纳入 1514 例患者（米拉贝隆组 613 例，抗毒蕈碱组 901 例）。两组的持续率随时间稳步下降。在每个时间点，添加或更换药物的患者比例较低。未调整的 Kaplan-Meier 分析显示两组的持续率相似。当根据患者特征（年龄、性别和 OAB 治疗状态）调整数据时，米拉贝隆组的持续率更高。未调整的中位至持续时间无显著差异。然而，任何原因导致的治疗结束持续时间更长与米拉贝隆有关（中位数：9.5 个月 vs 抗毒蕈碱组 6.7 个月）。HCP 表示，不持续治疗的最常见原因是症状无改善和对副作用的厌恶。
在控制患者特征后，与抗毒蕈碱药物相比，米拉贝隆的治疗持续性更长。任何原因导致的治疗结束持续时间也更长。
