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膀胱过度活动症治疗前6个月使用维贝格隆的满意度和持续性:4期真实世界COMPOSUR研究的中期结果

Satisfaction and persistence with vibegron in the first 6 months of overactive bladder treatment: interim results of the phase 4, real-world COMPOSUR study.

作者信息

Dmochowski Roger R, Rovner Eric S, Kennelly Michael J, Newman Diane K, Xavier Keith, Thomas Elizabeth, Snyder Daniel, Abedinzadeh Laleh

机构信息

Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.

Department of Urology, Medical University of South Carolina, Charleston, SC, USA.

出版信息

BMC Urol. 2025 Apr 2;25(1):66. doi: 10.1186/s12894-025-01742-6.

Abstract

BACKGROUND

The COMPOSUR study is evaluating vibegron for the treatment of overactive bladder (OAB) in a real-world setting. We report results of a prespecified 6-month interim analysis, assessing patient-reported treatment satisfaction, persistence, safety, and tolerability over the first 6 months after receiving a new prescription for vibegron.

METHODS

COMPOSUR (NCT05067478) is a 12-month, phase 4 study of vibegron. Patients were enrolled if they were ≥ 18 years of age with OAB, initiating vibegron after previously receiving anticholinergics (Cohort A) or mirabegron with/without anticholinergics (Cohort B). Satisfaction was assessed via the OAB Satisfaction With Treatment Questionnaire (OAB-SAT-q; domain scores on 0-100 scale, higher scores denoting greater satisfaction). The primary endpoint is the OAB-SAT-q satisfaction domain score. The key secondary endpoints are the percentage of positive responses to OAB-SAT-q questions 1-3 and 11. Additional secondary endpoints include OAB-SAT-q scores for side effects, endorsement, preference, and convenience. Persistence was assessed as an exploratory endpoint. Safety was assessed via adverse events (AEs).

RESULTS

A total of 403 patients were enrolled and initiated treatment with vibegron; 104 patients discontinued the study before month 6, most commonly owing to withdrawal of consent (n = 32) and AEs (n = 8). Mean (SD) patient age was 56.1 (12.5) years, and 29% were male. Overall, at 6 months, mean (SD) OAB-SAT-q domain scores were 70.0 (21.9) for satisfaction, 84.7 (20.6) for convenience, 91.1 (16.4) for side effects, and 80.4 (20.6) for endorsement. At 6 months, 85.6% (95% CI, 81.1%-90.1%) of patients preferred vibegron to previous OAB treatment. Most patients responded positively to individual OAB-SAT-questions; outcomes were similar from months 1 to 6 and in Cohorts A and B. Persistence with vibegron treatment at 6 months was 73.9% (95% CI, 69.3%-78.0%). Overall, 33.5% of patients experienced a treatment-emergent AE, most commonly (≥ 2% overall) urinary tract infection (4.0%), headache (2.7%), and dizziness (2.2%).

CONCLUSIONS

As of the 6-month interim analysis of the COMPOSUR study, most patients receiving vibegron were satisfied with treatment; satisfaction generally persisted from month 1 to 6, regardless of prior OAB treatment received. Treatment with vibegron was generally safe and well tolerated.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT05067478; registered: October 5, 2021.

摘要

背景

COMPOSUR研究正在真实环境中评估维贝格隆治疗膀胱过度活动症(OAB)的效果。我们报告了一项预先设定的6个月中期分析结果,评估患者报告的治疗满意度、持续性、安全性以及在接受维贝格隆新处方后的前6个月内的耐受性。

方法

COMPOSUR(NCT05067478)是一项为期12个月的维贝格隆4期研究。年龄≥18岁且患有OAB、在先前接受抗胆碱能药物治疗后开始使用维贝格隆的患者(队列A)或接受过米拉贝隆联合/不联合抗胆碱能药物治疗后开始使用维贝格隆的患者(队列B)被纳入研究。通过OAB治疗满意度问卷(OAB-SAT-q;领域得分采用0 - 100分制,得分越高表示满意度越高)评估满意度。主要终点是OAB-SAT-q满意度领域得分。关键次要终点是对OAB-SAT-q问题1 - 3和11的肯定回答百分比。其他次要终点包括OAB-SAT-q中关于副作用、认可、偏好和便利性的得分。持续性作为探索性终点进行评估。通过不良事件(AE)评估安全性。

结果

共有403名患者入组并开始使用维贝格隆治疗;104名患者在第6个月前停止研究,最常见的原因是撤回同意(n = 32)和不良事件(n = 8)。患者平均(标准差)年龄为56.1(12.5)岁,29%为男性。总体而言,在6个月时,OAB-SAT-q领域平均(标准差)满意度得分为70.0(21.9),便利性得分为84.7(20.6),副作用得分为91.1(16.4),认可得分为80.4(20.6)。在6个月时,85.6%(95%置信区间,81.1% - 90.1%)的患者相较于先前的OAB治疗更喜欢维贝格隆。大多数患者对OAB-SAT-q的各个问题回答为肯定;1至6个月以及队列A和B的结果相似。6个月时维贝格隆治疗的持续性为73.9%(95%置信区间,69.3% - 78.0%)。总体而言,33.5%的患者经历了治疗中出现的不良事件,最常见的(总体≥2%)是尿路感染(4.0%)、头痛(2.7%)和头晕(2.2%)。

结论

截至COMPOSUR研究的6个月中期分析,大多数接受维贝格隆治疗患者对治疗满意;无论先前接受何种OAB治疗,满意度通常从第1个月持续到第6个月。维贝格隆治疗总体安全且耐受性良好。

试验注册

ClinicalTrials.gov标识符:NCT05067478;注册时间:2021年10月5日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/774f/11963645/221812da7ff4/12894_2025_1742_Fig1_HTML.jpg

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