Kinjo Manami, Masuda Kazuki, Nakamura Yu, Taguchi Satoru, Tambo Mitsuhiro, Fukuhara Hiroshi
Department of Urology, Kyorin University School of Medicine, 6-20-2 Shinkawa Mitaka-shi, Tokyo, 181-8611, Japan.
Int Urogynecol J. 2023 Apr;34(4):853-859. doi: 10.1007/s00192-022-05261-y. Epub 2022 Jun 14.
We aimed to determine whether the presence of metabolic syndrome (MS) affects the efficacy of mirabegron in treatment-naïve women with overactive bladder (OAB).
Women being treated with mirabegron 50 mg were allocated to MS and non-MS groups, and the efficacy of treatment of OAB was compared using the OAB symptom score (OABSS) and a 3-day voiding diary before and 12 weeks after starting treatment. The Wilcoxon signed-rank and Mann-Whitney U tests and multivariate logistic regression were used for statistical analyses, and a p-value < 0.05 was considered to represent statistical significance.
Of the 197 patients who completed the trial, 43 (23.9%) had MS. After 12 weeks of mirabegron treatment, both the MS and non-MS groups showed significant improvements in OABSS score, the number of incontinence episodes/24 h, the number of micturition episodes/24 h, and the number of episodes of urgency/24 h. The factors associated with clinically important differences in OABSS were the presence of hyperglycemia (odds ratio 2.43, 95% confidence interval [CI] 1.05-5.60) and OABSS score at baseline (odds ratio 1.23, 95% CI 1.09-1.39).
Mirabegron is effective in patients with and without MS, and comorbid hyperglycemia and severe OAB symptoms before treatment are predictors of the efficacy of mirabegron treatment.
我们旨在确定代谢综合征(MS)的存在是否会影响米拉贝隆对初治膀胱过度活动症(OAB)女性患者的疗效。
将接受50毫克米拉贝隆治疗的女性分为MS组和非MS组,在开始治疗前及治疗12周后,使用OAB症状评分(OABSS)和3天排尿日记比较OAB的治疗效果。采用Wilcoxon符号秩检验、Mann-Whitney U检验和多因素逻辑回归进行统计分析,p值<0.05被认为具有统计学意义。
在197例完成试验的患者中,43例(23.9%)患有MS。米拉贝隆治疗12周后,MS组和非MS组的OABSS评分、24小时尿失禁发作次数、24小时排尿次数和24小时尿急发作次数均有显著改善。与OABSS临床重要差异相关的因素是高血糖的存在(比值比2.43,95%置信区间[CI]1.05-5.60)和基线时的OABSS评分(比值比1.23,95%CI 1.09-1.39)。
米拉贝隆对有或无MS的患者均有效,治疗前合并高血糖和严重OAB症状是米拉贝隆治疗疗效的预测因素。