Müderrisoglu A Elif, Sakul Ayse A, Murgas Sandra, de la Rosette Jean J M C H, Michel Martin C
Department of Medical Pharmacology, Istanbul Medipol University, Istanbul, Türkiye.
APOGEPHA Arzneimittel GmbH, Dresden, Germany.
Front Pharmacol. 2023 Mar 30;14:1144470. doi: 10.3389/fphar.2023.1144470. eCollection 2023.
Pelvic hypoperfusion caused by atherosclerosis has been proposed as a cause of lower urinary tract dysfunction including overactive bladder syndrome (OAB). Limited data indicate that OAB patients with concomitant diabetes or hypertension, known risk factors of atherosclerosis, may exhibit greater baseline OAB symptoms and slightly smaller therapeutic responses to treatment, but the impact of a combined presence of diabetes and hypertension has not been reported. Therefore, we have explored whether the combined presence of both comorbidities is associated with greater baseline OAB symptoms than that of either comorbidity alone. Secondary questions were exploration of the impact of either comorbidity on baseline symptoms, and of the impact of either comorbidity alone and their combination on therapeutic responses. Data from two non-interventional studies applying treatment with propiverine ER 30 or 45 mg/d for 12 weeks were analyzed. Number of urgency episodes in the combination group was greater than with each comorbidity alone. The impact of comorbidities on baseline intensity of incontinence, frequency or nocturia or Patient Perception of Bladder Condition was less consistent or absent. Either comorbidity alone was associated with a smaller % improvement of symptoms, and their combination had a greater effect than either alone. However, all attenuations associated with comorbidity were small relative to the overall improvement. We conclude that comorbidities of diabetes and hypertension have detectable effects on OAB symptoms and treatment responses, but the small magnitude of these alterations does not justify changing existing paradigms for the clinical management of OAB.
动脉粥样硬化引起的盆腔灌注不足被认为是包括膀胱过度活动症（OAB）在内的下尿路功能障碍的一个原因。有限的数据表明，伴有动脉粥样硬化已知危险因素糖尿病或高血压的OAB患者可能表现出更严重的基线OAB症状，且对治疗的反应略小，但糖尿病和高血压合并存在的影响尚未见报道。因此，我们探讨了这两种合并症同时存在是否比单独存在任何一种合并症与更严重的基线OAB症状相关。次要问题是探讨每种合并症对基线症状的影响，以及每种合并症单独存在及其联合存在对治疗反应的影响。分析了两项非干预性研究的数据，这两项研究应用30或45mg/d的缓释丙哌维林治疗12周。合并症组的尿急发作次数比单独存在每种合并症时更多。合并症对尿失禁、尿频或夜尿的基线严重程度或患者膀胱状况感知的影响不太一致或不存在。单独存在任何一种合并症都与症状改善百分比更小相关，且它们的联合作用比单独任何一种合并症的作用更大。然而，相对于总体改善而言，与合并症相关的所有减弱作用都较小。我们得出结论，糖尿病和高血压合并症对OAB症状和治疗反应有可检测到的影响，但这些改变的程度较小，不足以改变OAB临床管理的现有模式。
