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开放性标签、经尿道腔内给药(TRG-100)利多卡因和奥昔布宁缓释系统治疗间质性膀胱炎/膀胱疼痛综合征、膀胱过度活动症和内镜术后留置输尿管支架患者的安全性和疗效的初步研究。

Open Label, Pilot Evaluation of the Safety and Efficacy of Intravesical Sustained Release System of Lidocaine and Oxybutynin (TRG-100) for Patients With Interstitial Cystitis/Bladder Pain Syndrome, Overactive Bladder and Patients With Retained Ureteral Stents Following Endourological Interventions.

机构信息

Department of Urology, Shaare Zedek Medical Center, Faculty of Medicine Hebrew University, Jerusalem, Israel.

Department of Urology, Shaare Zedek Medical Center, Faculty of Medicine Hebrew University, Jerusalem, Israel.

出版信息

Urology. 2023 Aug;178:42-47. doi: 10.1016/j.urology.2023.05.016. Epub 2023 Jun 1.

Abstract

BACKGROUND

Intravesical instillation of analgesic and anticholinergic drugs have shown efficacy in the treatment of pain and voiding symptoms. Unfortunately, drug loss with urination and dilution in the bladder limit their durability and clinical usefulness. We have recently developed and tested in vitro, a sustained delivery system (TRG-100) of fixed-dose combination of lidocaine and oxybutynin designed to allow for a longer exposure of the urinary bladder to the drugs.

OBJECTIVE

To asses the safety and efficacy of TRG-100 in Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS), overactive bladder (OAB), and endourological intervention stented (EUI) patients in an open-label, prospective study.

METHODS

Thirty-six patients were enrolled: 10 IC/BPS, 10 OAB, and 16 EUI. EUI patients received a once-weekly installation until stent removal, OAB and IC/BPS patient received weekly installations for 4 consecutive weeks. Treatment effect was assessed by visual analog scale (VAS) score for the EUI group, voiding diaries for OAB group and VAS score, voiding diaries and O'Leary Sant Questionnaires for the IC/BPS group.

RESULTS

The EUI group showed a mean 4-point improvement in their VAS score. The OAB group showed 33.54% reduction in frequency of urination and IC/PBS group showed a mean of 3.2-point improvement in their VAS score, 25.43% reduction in frequency of urination, and a mean 8.1-point reduction in O'Leary Sant Questionnaires score. All changes were statistically significant.

CONCLUSION

Intravesical instillation of TRG-100 was found to be safe and efficient in reducing pain and irritative bladder symptoms in our study population. TRG-100 efficacy and safety should be further assessed in a large, randomized control trial.

摘要

背景

膀胱内灌注镇痛和抗胆碱能药物已被证明对治疗疼痛和排尿症状有效。不幸的是,药物随尿液流失和在膀胱内稀释限制了它们的持久性和临床实用性。我们最近开发并在体外测试了一种固定剂量组合利多卡因和奥昔布宁的缓释系统(TRG-100),旨在使膀胱更长时间暴露于药物中。

目的

在一项开放标签、前瞻性研究中,评估 TRG-100 在间质性膀胱炎/膀胱疼痛综合征(IC/BPS)、膀胱过度活动症(OAB)和内镜介入置管(EUI)患者中的安全性和疗效。

方法

共纳入 36 例患者:10 例 IC/BPS,10 例 OAB,16 例 EUI。EUI 患者每周安装一次,直至支架取出;OAB 和 IC/BPS 患者每周安装一次,连续 4 周。通过视觉模拟评分(VAS)评估 EUI 组的治疗效果,通过排尿日记评估 OAB 组的治疗效果,通过 VAS 评分和 O'Leary Sant 问卷评估 IC/BPS 组的治疗效果。

结果

EUI 组 VAS 评分平均改善 4 分。OAB 组排尿次数减少 33.54%,IC/PBS 组 VAS 评分平均改善 3.2 分,排尿次数减少 25.43%,O'Leary Sant 问卷评分平均降低 8.1 分。所有变化均具有统计学意义。

结论

在本研究人群中,膀胱内灌注 TRG-100 被发现安全有效,可降低疼痛和刺激性膀胱症状。TRG-100 的疗效和安全性应在更大的随机对照试验中进一步评估。

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