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PINNACLE 研究:一项双盲、随机、假对照研究,评估 Optilume BPH 导管系统治疗良性前列腺增生引起的下尿路症状。

The PINNACLE Study: A Double-blind, Randomized, Sham-controlled Study Evaluating the Optilume BPH Catheter System for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia.

机构信息

Icahn School of Medicine at Mount Sinai, New York, New York.

Oschner LSU Health, Shreveport, Louisiana.

出版信息

J Urol. 2023 Sep;210(3):500-509. doi: 10.1097/JU.0000000000003568. Epub 2023 Aug 9.

DOI:10.1097/JU.0000000000003568
PMID:37555604
Abstract

PURPOSE

The Optilume BPH Catheter System is a novel drug/device combination minimally invasive surgical therapy for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia. The PINNACLE study is a prospective, randomized, double-blind, sham-controlled clinical trial evaluating the safety and efficacy of Optilume BPH against a sham surgical procedure.

MATERIALS AND METHODS

Eligible patients were men 50 years or older with symptomatic benign prostatic hyperplasia and a prostate size between 20 and 80 g. Subjects were randomized 2:1 to receive treatment with Optilume BPH or a sham surgical procedure. Blinding was maintained for subjects in both arms and evaluating personnel through 1 year postprocedure. Follow-up assessments included the International Prostate Symptom Score, uroflowmetry, and other quality-of-life and sexual function assessments.

RESULTS

A total of 148 men were randomized (100 active, 48 sham) at 18 centers in the U.S. and Canada. Subjects randomized to receive Optilume BPH saw a reduction in International Prostate Symptom Score of 11.5±7.8 points at 1 year posttreatment, as compared to a reduction of 8.0±8.3 points at 3 months in the sham arm. Flow rate was dramatically improved after treatment with Optilume BPH, with an improvement of +10.3 mL/s from baseline to 1 year (+125%).

CONCLUSIONS

Treatment with Optilume BPH provides immediate and sustained improvements in obstructive symptoms and flow rate while preserving erectile and ejaculatory function. Treatment is well tolerated and can be done in an office or ambulatory setting.

摘要

目的

Optilume BPH 导管系统是一种新型药物/器械联合微创外科治疗方法,用于治疗良性前列腺增生引起的下尿路症状。PINNACLE 研究是一项前瞻性、随机、双盲、假手术对照临床试验,评估 Optilume BPH 治疗良性前列腺增生的安全性和疗效。

材料和方法

符合条件的患者为年龄在 50 岁或以上、有症状的良性前列腺增生且前列腺大小在 20 至 80 克之间的男性。患者按 2:1 随机分为 Optilume BPH 治疗组或假手术组。对两组患者和评估人员均保持盲法至术后 1 年。随访评估包括国际前列腺症状评分、尿流率以及其他生活质量和性功能评估。

结果

在美国和加拿大的 18 个中心共招募了 148 名男性患者(100 名活性,48 名假手术)。接受 Optilume BPH 治疗的患者在治疗后 1 年时的国际前列腺症状评分降低了 11.5±7.8 分,而假手术组在 3 个月时降低了 8.0±8.3 分。Optilume BPH 治疗后尿流率显著改善,从基线到 1 年增加了+10.3mL/s(增加 125%)。

结论

Optilume BPH 治疗可立即改善和维持梗阻症状和尿流率,同时保留勃起和射精功能。治疗耐受性良好,可在办公室或门诊环境中进行。

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