膀胱过度活动症不同类型治疗方法的比较：一项系统评价和网状Meta分析。

Comparison of different types of therapy for overactive bladder: A systematic review and network meta-analysis.

作者信息

Liu Peng, Li Yan, Shi Benkang, Zhang Qiujie, Guo Hu

机构信息

Department of Urology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.

出版信息

Front Med (Lausanne). 2022 Oct 20;9:1014291. doi: 10.3389/fmed.2022.1014291. eCollection 2022.

UNLABELLED

To compare the efficacy and safety of different interventions [including antimuscarinics, mirabegron, OnabotulinumtoxinA, sacral neuromodulation (SNM) and peripheral tibial nerve stimulation (PTNS)] for treating idiopathic overactive bladder (OAB). PubMed, Embase, Cochrane Library, and other sources were searched for randomized controlled trials (RCTs) comparing interventions for overactive bladder from 1 January 2000 to 19 April 2021. A systematic review and network meta-analysis were performed by two authors independently. Fifty-five RCTs involving 32,507 patients were included in this analysis. Overall, antimuscarinics, mirabegron, OnabotulinumtoxinA, sacral neuromodulation, and peripheral tibial nerve stimulation were more efficacious than placebo, and sacral neuromodulation showed the best effect for reducing micturition frequency, urgency episodes and urgency urinary incontinence episodes. OnabotulinumtoxinA was the best intervention for achieving reductions of 100 and ≥50% in the number of urinary incontinence episodes/day, and peripheral tibial nerve stimulation was the best intervention for reducing urinary incontinence episodes. Antimuscarinics, mirabegron and peripheral tibial nerve stimulation had a similar efficacy for reducing micturition frequency, urinary incontinence episodes and urgency urinary incontinence episodes. The results revealed that all interventions examined herein were efficacious for managing adult overactive bladder syndrome compared with placebo. Furthermore, sacral neuromodulation and OnabotulinumtoxinA were the most efficient treatments for overactive bladder.

SYSTEMATIC REVIEW REGISTRATION

[https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=251966], identifier [CRD42021251966].

未标注

比较不同干预措施（包括抗毒蕈碱药物、米拉贝隆、A型肉毒毒素、骶神经调节术（SNM）和胫神经外周刺激术（PTNS））治疗特发性膀胱过度活动症（OAB）的疗效和安全性。检索了PubMed、Embase、Cochrane图书馆及其他来源，以查找2000年1月1日至2021年4月19日期间比较膀胱过度活动症干预措施的随机对照试验（RCT）。由两位作者独立进行系统评价和网状Meta分析。本分析纳入了55项涉及32507例患者的RCT。总体而言，抗毒蕈碱药物、米拉贝隆、A型肉毒毒素、骶神经调节术和胫神经外周刺激术比安慰剂更有效，骶神经调节术在减少排尿频率、尿急发作和急迫性尿失禁发作方面效果最佳。A型肉毒毒素是使每日尿失禁发作次数减少100次及≥50%的最佳干预措施，胫神经外周刺激术是减少尿失禁发作的最佳干预措施。抗毒蕈碱药物、米拉贝隆和胫神经外周刺激术在减少排尿频率、尿失禁发作和急迫性尿失禁发作方面疗效相似。结果显示，与安慰剂相比，本文研究的所有干预措施对治疗成人膀胱过度活动症均有效。此外，骶神经调节术和A型肉毒毒素是治疗膀胱过度活动症最有效的方法。