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代谢综合征是否会影响米拉贝隆治疗女性膀胱过度活动症患者的疗效?

Does metabolic syndrome influence the efficacy of mirabegron treatment in female patients with overactive bladder?

作者信息

Kinjo Manami, Masuda Kazuki, Nakamura Yu, Taguchi Satoru, Tambo Mitsuhiro, Fukuhara Hiroshi

机构信息

Department of Urology, Kyorin University School of Medicine, 6-20-2 Shinkawa Mitaka-shi, Tokyo, 181-8611, Japan.

出版信息

Int Urogynecol J. 2023 Apr;34(4):853-859. doi: 10.1007/s00192-022-05261-y. Epub 2022 Jun 14.

Abstract

INTRODUCTION AND HYPOTHESIS

We aimed to determine whether the presence of metabolic syndrome (MS) affects the efficacy of mirabegron in treatment-naïve women with overactive bladder (OAB).

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

摘要

引言与假设

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。

方法

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。

结果

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)。

结论

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。

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