Faculdade de Ciências Medicas da Santa Casa de São Paulo, São Paulo, SP, Brazil.
Faculdade de Medicina de Marilia, São Paulo, Marília, SP, Brazil.
Rev Bras Ginecol Obstet. 2023 Jun;45(6):337-346. doi: 10.1055/s-0043-1770093. Epub 2023 Jul 21.
To compare the use of mirabegron with anticholinergics drugs for the treatment of overactive bladder (OB).
Systematic searches were conducted in EMBASE, PUBMED, Cochrane, and LILACS databases from inception to September 2021. We included RCTs, women with clinically proven OB symptoms, studies that compared mirabegron to antimuscarinic drugs, and that evaluated the efficacy, safety or adherence.
RevMan 5.4 was used to combine results across studies. We derived risk ratios (RRs) and mean differences with 95% CIs using a random-effects meta-analytic model. Cochrane Collaboration Tool and GRADE was applied for risk of bias and quality of the evidence.
We included 14 studies with a total of 10,774 patients. Fewer total adverse events was reported in mirabegron group than in antimuscarinics group [RR 0.93 (0.89-0.98)]. The risk of gastrointestinal tract disorders and dry mouth were lower with mirabegron [RR 0,58 (0.48-0.68); 9375 patients; RR 0.44 (0.35-0.56), 9375 patients, respectively]. No difference was reported between mirabegron and antimuscarinics drugs for efficacy. The adherence to treatment was 87.7% in both groups [RR 0.99 (0.98-1.00)].
Mirabegron and antimuscarinics have comparable efficacy and adherence rates; however, mirabegron showed fewer total and isolated adverse events.
比较米拉贝隆与抗胆碱能药物治疗膀胱过度活动症（OAB）的效果。
系统检索 EMBASE、PUBMED、Cochrane 和 LILACS 数据库，检索时间截至 2021 年 9 月。纳入 RCT、有临床确诊 OAB 症状的女性患者、比较米拉贝隆与抗毒蕈碱药物且评估疗效、安全性或依从性的研究。
使用 RevMan 5.4 对各项研究结果进行合并。采用随机效应荟萃分析模型，得出风险比（RR）和均数差值及其 95%置信区间（CI）。采用 Cochrane 协作工具和 GRADE 对偏倚风险和证据质量进行评估。
共纳入 14 项研究，共计 10774 例患者。米拉贝隆组的总不良事件发生率低于抗毒蕈碱组[RR 0.93（0.89-0.98）]。米拉贝隆组胃肠道疾病和口干的风险较低[RR 0.58（0.48-0.68），9375 例患者；RR 0.44（0.35-0.56），9375 例患者]。米拉贝隆与抗毒蕈碱药物在疗效方面无差异。两组的治疗依从率均为 87.7%[RR 0.99（0.98-1.00）]。
米拉贝隆与抗毒蕈碱药物具有相似的疗效和依从率，但米拉贝隆的总不良事件和单一不良事件发生率较低。
