Long-Term Efficacy of Mirabegron Add-On Therapy to Antimuscarinic Agents in Patients With Spinal Cord Injury
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective To evaluate the long-term efficacy of mirabegron add-on therapy in patients with spinal cord injury (SCI) based on an urodynamic study. Methods This retrospective study involved a chart audit of individuals with SCI who underwent two consecutive urodynamic studies between April 1, 2015 and April 1, 2018. After adding 50 mg of mirabegron once a day to the pre-existing antimuscarinic therapy for a period of, at least 6 months, the following variables were analyzed: change in cystometric capacity, change in bladder compliance, change in maximal detrusor pressure, change in reflex volume, and presence of significant leakage during filling cystometry. Results A total of 31 participants with a mean age of 41±15 years were included in the analysis. A significant increase in cystometric capacity (mean, 362 to 424 mL; p=0.03), reflex volume (mean, 251 to 329 mL; p=0.02), and bladder compliance (median, 12 to 18 mL/cmH2O; p=0.04) was observed. The presence of leakage during filling cystometry was significantly reduced (29% to 10%; p=0.03). Likewise, a non-significant decrease in the change in maximal detrusor pressure was observed (mean, 31 to 27 cmH2O; p=0.39). Conclusion Adding mirabegron to conventional antimuscarinics further improved urodynamic parameters in patients with chronic SCI, and sustained efficacy was observed in long-term use.
Abstract
Objective To evaluate the long-term efficacy of mirabegron add-on therapy in patients with spinal cord injury (SCI) based on an urodynamic study. Methods This retrospective study involved a chart audit of individuals with SCI who underwent two consecutive urodynamic studies between April 1, 2015 and April 1, 2018. After adding 50 mg of mirabegron once a day to the pre-existing antimuscarinic therapy for a period of, at least 6 months, the following variables were analyzed: change in cystometric capacity, change in bladder compliance, change in maximal detrusor pressure, change in reflex volume, and presence of significant leakage during filling cystometry. Results A total of 31 participants with a mean age of 41±15 years were included in the analysis. A significant increase in cystometric capacity (mean, 362 to 424 mL; p=0.03), reflex volume (mean, 251 to 329 mL; p=0.02), and bladder compliance (median, 12 to 18 mL/cmH2O; p=0.04) was observed. The presence of leakage during filling cystometry was significantly reduced (29% to 10%; p=0.03). Likewise, a non-significant decrease in the change in maximal detrusor pressure was observed (mean, 31 to 27 cmH2O; p=0.39). Conclusion Adding mirabegron to conventional antimuscarinics further improved urodynamic parameters in patients with chronic SCI, and sustained efficacy was observed in long-term use.
참고문헌 (30)
- Gerridzen RG, "Risk factors for upper tract deterioration in chronic spinal cord injury patients", J Urol, 147, pp.416~418 (1992)
- Goldmark E, "Neurogenic bladder : from diagnosis to management", Curr Urol Rep, 15, pp.448~ (2014)
- Abrams P, "Assessment of treatment outcomes in patients with overactive bladder: importance of objective and subjective measures", Urology, 68(2 Suppl), pp.17~28 (2006)
- del Popolo G, "Controversy over the pharmacological treatments of storage symptoms in spinal cord injury patients : a literature overview", Spinal Cord, 50, pp.8~13 (2012)
- Benner JS, "Patient-reported reasons for discontinuing overactive bladder medication", BJU Int, 105, pp.1276~1282 (2010)
- Maman K, "Comparative efficacy and safety of medical treatments for the management of overactive bladder : a systematic literature review and mixed treatment comparison", Eur Urol, 65, pp.755~765 (2014)
- Wollner J, "Initial experience with the treatment of neurogenic detrusor overactivity with a new β-3 agonist(mirabegron)in patients with spinal cord injury", Spinal Cord, 54, pp.78~82 (2016)
- Kirshblum S, "Updates for the international standards for neurological classification of spinal cord injury", Phys Med Rehabil Clin N Am, 25, pp.505~517 (2014)
- Kirshblum SC, "Reference for the 2011 revision of the international standards for neurological classification of spinal cord injury", J Spinal Cord Med, 34, pp.547~554 (2011)
- Yamanishi T, "Role of urodynamic studies in the diagnosis and treatment of lower urinary tract symptoms", Urol Sci, 22, pp.120~128 (2011)
- Abrams P, "The standardisation of terminology in lower urinary tract function : report from the standardisation sub-committee of the International Continence Society", Urology, 61, pp.37~49 (2003)
- Homma Y, "Incontinence: the 2nd International consultation on incontinence", pp.317~372 (2002), Plymbridge Distributors
- Krebs J, "Effects of solifenacin in patients with neurogenic detrusor overactivity as a result of spinal cord lesion", Spinal Cord, 51, pp.306~309 (2013)
- 김지형, "How to Calculate Sample Size and Why", Clinics in Orthopedic Surgery, 5(3), pp.235~242 (2013), 대한정형외과학회
- Rosner B, "Fundamentals of biostatistics" (1995), Duxbury Press
- Ginsberg D, "The epidemiology and pathophysiology of neurogenic bladder", Am J Manag Care, 19(10 Suppl), pp.s191~s196 (2013)
- Panicker JN, "Lower urinary tract dysfunction in the neurological patient : clinical assessment and management", Lancet Neurol, 14, pp.720~732 (2015)
- Groen J, "Summary of European Association of Urology(EAU)guidelines on neuro-urology", Eur Urol, 69, pp.324~333 (2016)
- Stohrer M, "EAU guidelines on neurogenic lower urinary tract dysfunction", Eur Urol, 56, pp.81~88 (2009)
- Stohrer M, "Propiverine compared to oxybutynin in neurogenic detrusor overactivity : results of a randomized, double-blind, multicenter clinical study", Eur Urol, 51, pp.235~242 (2007)
- Staskin DR, "Using anticholinergics to treat overactive bladder: the issue of treatment tolerability", Am J Med, 119(3 Suppl 1), pp.9~15 (2006)
- Nitti VW, "Efficacy and tolerability of tolterodine extended-release in continent patients with overactive bladder and nocturia", BJU Int, 97, pp.1262~1266 (2006)
- Amend B, "Effective treatment of neurogenic detrusor dysfunction by combined high-dosed antimuscarinics without increased side-effects", Eur Urol, 53, pp.1021~1028 (2008)
- Takeda M, "Evidence for beta3-adrenoceptor subtypes in relaxation of the human urinary bladder detrusor : analysis by molecular biological and pharmacological methods", J Pharmacol Exp Ther, 288, pp.1367~1373 (1999)
- Yamaguchi O, "Beta3-adrenoceptors in human detrusor muscle", Urology, 59(5 Suppl 1), pp.25~29 (2002)
- Madhuvrata P, "Anticholinergic drugs for adult neurogenic detrusor overactivity : a systematic review and meta-analysis", Eur Urol, 62, pp.816~830 (2012)
- Matsukawa Y, "Urodynamic evaluation of the efficacy of mirabegron on storage and voiding functions in women with overactive bladder", Urology, 85, pp.786~790 (2015)
- Vecchioli Scaldazza C, "Comparison of therapeutic efficacy and urodynamic findings of solifenacin succinate versus mirabegron in women with overactive bladder syndrome : results of a randomized controlled study", Urol Int, 97, pp.325~329 (2016)
- Wada N, "Urodynamic efficacy and safety of mirabegron add-on treatment with tamsulosin for Japanese male patients with overactive bladder", Low Urin Tract Symptoms, 8, pp.171~176 (2016)
- Krhut J, "Efficacy and safety of mirabegron for the treatment of neurogenic detrusor overactivity-Prospective, randomized, double-blind, placebocontrolled study", Neurourol Urodyn, 37, pp.2226~2233 (2018)