Mirabegron Versus Placebo and Other Therapeutic Modalities in the Treatment of Patients with Overactive Bladder Syndrome-A Systematic Review.

IF 5.4 3区材料科学 Q2 CHEMISTRY, PHYSICAL

ACS Applied Energy Materials Pub Date : 2024-09-28 DOI:10.1016/j.euf.2024.09.012

Anirban Dey, Georgios Georgiadis, Justin Umezurike, Yuhong Yuan, Fawzy Farag, James N'Dow, Muhammad Imran Omar, Charalampos Mamoulakis

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引用次数: 0

Abstract

Background and objective: The prevalence of overactive bladder (OAB) increases with age. Mirabegron and other drugs are used for the management of patients with OAB. To evaluate mirabegron versus other treatments for overactive bladder syndrome (OAB).

Methods: This randomised controlled trial (RCT)-based systematic review (CRD42020200394) was conducted following the 2020 Preferred Reporting Items for Systematic Reviews and Meta-analyses statement, with standards reported in the Cochrane Handbook for Systematic Reviews of Interventions.

Key findings and limitations: We included 28 RCTs (n = 27 481 adults), comparing the following: mirabegron 25 mg versus placebo (n = 8798; six RCTs): significant changes in urgency urinary incontinence (mean difference [MD] -0.41, 95% confidence interval [CI] -0.56 to -0.26), total incontinence (MD -0.47, 95% CI -0.63 to -0.30), and nocturia (MD -0.10, 95% CI -0.17 to -0.02), and mirabegron 50 mg versus placebo (n = 14 933; 12 RCTs): significant changes in urgency urinary incontinence (MD -0.41, 95% CI -0.52 to -0.31), urgency (MD -0.49, 95% CI -0.64 to -0.33), total incontinence (MD -0.44, 95% CI -0.55 to -0.33), favouring mirabegron 25/50 mg; mirabegron 50 mg versus tolterodine 4 mg (n = 8008; five RCTs): significant changes in micturition (MD -0.16, 95% CI -0.31 to -0.02) and overall adverse events (AEs; odds ratio [OR] 0.71, 95% CI 0.59-0.86), favouring mirabegron 50 mg; mirabegron 50 mg versus solifenacin 5 mg (n = 8911; four RCTs): significant changes in voided volume/micturition in millilitres (MD -7.77, 95% CI -12.93 to -2.61), favouring mirabegron 50 mg; and mirabegron 50 mg versus oxybutynin 73.5 mg (n = 302; one RCT): significant changes in overall AEs (OR 0.02, 95% CI 0.00-0.16), favouring mirabegron 50 mg.

Conclusions and clinical implications: Mirabegron is effective, safe, and well tolerated. Coadministration with anticholinergics provides an advantageous additive effect without a higher occurrence of side effects.

Patient summary: Mirabegron is effective, safe, and well tolerated for treating overactive bladder. When used in conjunction with anticholinergic medications, it provides extra benefits without causing more side effects.

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米拉贝琼与安慰剂及其他治疗方式在膀胱过度活动综合征患者治疗中的对比--系统性综述。

背景和目的：膀胱过度活动症（OAB）的发病率随着年龄的增长而增加。米拉贝琼和其他药物被用于治疗膀胱过度活动症患者。评估米拉贝琼与其他治疗膀胱过度活动症（OAB）的方法：这项基于随机对照试验（RCT）的系统综述（CRD42020200394）是根据《2020 年系统综述和荟萃分析首选报告项目》声明进行的，其标准见《干预措施系统综述科克伦手册》：我们纳入了 28 项 RCT（n = 27 481 名成人），比较了以下方面：米拉贝琼 25 毫克与安慰剂（n = 8798；6 项 RCT）：急迫性尿失禁（平均差 [MD] -0.41，95% 置信区间 [CI] -0.56 至 -0.26）、总尿失禁（MD -0.47，95% CI -0.63 至 -0.30）和夜尿增多（MD -0.47，95% CI -0.63 至 -0.26）的显著变化。30）和夜尿（MD -0.10，95% CI -0.17至-0.02），以及米拉贝琼50毫克与安慰剂相比（n = 14 933；12项RCTs）：尿急尿失禁（MD -0.41，95% CI -0.52至-0.31）、尿急（MD -0.49，95% CI -0.64至-0.33）、总尿失禁（MD -0.44，95% CI -0.55至-0.33），更倾向于米拉贝琼 25/50 mg；米拉贝琼 50 mg 对托特罗定 4 mg（n = 8008；5 项 RCT）：排尿（MD -0.16，95% CI -0.31 至 -0.02）和总体不良事件（AEs；几率比 [OR] 0.71，95% CI 0.59-0.86），支持米拉贝琼 50 毫克；米拉贝琼 50 毫克对索利那新 5 毫克（n = 8911；4 项 RCT）：以毫升为单位的排尿量/排尿次数显著变化（MD -7.77，95% CI -12.93至-2.61），米拉贝琼50毫克更优；米拉贝琼50毫克与奥昔布宁73.5毫克相比（n = 302；1项RCT）：总体AEs显著变化（OR 0.02，95% CI 0.00-0.16），米拉贝琼50毫克更优：米拉贝琼有效、安全且耐受性良好。患者总结：米拉贝琼治疗膀胱过度活动症有效、安全且耐受性良好。米拉贝琼与抗胆碱能药物联合使用时，可产生额外的疗效，而不会产生更多的副作用。

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来源期刊

ACS Applied Energy Materials Materials Science-Materials Chemistry

CiteScore

10.30

自引率

6.20%

发文量

1368

期刊介绍： ACS Applied Energy Materials is an interdisciplinary journal publishing original research covering all aspects of materials, engineering, chemistry, physics and biology relevant to energy conversion and storage. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrate knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important energy applications.