He Wenjuan, Zhang Yuqian, Huang Guangliang, Tian Yunfei, Sun Qian, Liu Xiuju
Department of Pharmacy, The Second Hospital of HeBei Medical University, Shijiazhuang, China.
Department of Clinical Pharmacy, HeBei Medical University, Shijiazhuang, China.
Low Urin Tract Symptoms. 2023 May;15(3):80-88. doi: 10.1111/luts.12475. Epub 2023 Mar 2.
The aim of this study was to indirectly compare the efficacy and safety of mirabegron and vibegron in patients with overactive bladder.
A systematic search was performed on Pubmed, Web of Science, Embase, and the Cochrane Central Register of Controlled Trials databases to identify studies from the date of database inception to January 1, 2022. All randomized controlled trials comparing mirabegron or vibegron with tolterodine, imidafenacin, or placebo were eligible. One reviewer extracted data, and a second reviewer checked. Included trials were assessed for similarity, and networks were developed using Stata 16.0 software. Mean differences for continuous variables and odds ratios for dichotomous variables together with their 95% confidence intervals (CIs) were used to rank treatments and compare the differences, respectively.
A total of 11 randomized controlled trials and 10 806 patients were included. For each outcome, results for all licensed treatment doses were included. Both vibegron and mirabegron were more efficacious than placebo at reducing the frequency of micturition, incontinence, urgency, urgency incontinence, and nocturia. Vibegron was more efficacious than mirabegron in reducing mean voided volume/micturition (95% CI [5.15, 14.98]). Safety outcomes for vibegron and mirabegron were similar to those in the placebo group, except for mirabegron, which had a higher risk of nasopharyngitis and cardiovascular adverse events than placebo.
Both drugs seem to be comparable and well tolerated, particularly as direct comparisons are not available. However, vibegron may be more effective than mirabegron in reducing mean voided volume.
本研究旨在间接比较米拉贝隆和维贝隆对膀胱过度活动症患者的疗效和安全性。
在PubMed、科学网、Embase和Cochrane对照试验中央注册库数据库中进行系统检索，以识别从数据库建立之日至2022年1月1日的研究。所有比较米拉贝隆或维贝隆与托特罗定、咪达那新或安慰剂的随机对照试验均符合条件。由一名审阅者提取数据，另一名审阅者进行核对。对纳入的试验进行相似性评估，并使用Stata 16.0软件构建网络。连续变量的平均差和二分变量的比值比及其95%置信区间（CI）分别用于对治疗进行排序和比较差异。
共纳入11项随机对照试验和10806例患者。对于每个结局，纳入了所有批准治疗剂量的结果。在减少排尿频率、尿失禁、尿急、急迫性尿失禁和夜尿症方面，维贝隆和米拉贝隆均比安慰剂更有效。在减少平均排尿量/排尿次数方面，维贝隆比米拉贝隆更有效（95%CI[5.15，14.98]）。维贝隆和米拉贝隆的安全性结局与安慰剂组相似，但米拉贝隆患鼻咽炎和心血管不良事件的风险高于安慰剂。
这两种药物似乎具有可比性且耐受性良好，尤其是在无法进行直接比较的情况下。然而，在减少平均排尿量方面，维贝隆可能比米拉贝隆更有效。
