摘要
抗毒蕈碱是目前的膀胱过度活动症(OAB)综合征的药物治疗的中流砥柱。尽管临床试验中记录的参数差异的临床意义受到质疑,通过荟萃分析,与安慰剂相比,抗毒蕈碱的疗效已经得到证实。试验对检测了抗毒蕈碱对患者的影响作用,如主观治愈/改善率,生活质量参数和成本效益相对有限。此外,为了满足注册要求,不在对需要为特殊病人评估最佳治疗方案还是第二选择的医生提供关键信 ,现有的药物之间的比较研究已经开始进行。对从事治疗OAB个体病人的临床医生有用的数据可以从系统综述/Meta分析,成本效益研究以及患者药物治疗OAB的依从性和持久性研究中得到。此外,应该综合考虑病人的合并症和并发处理应与每种抗毒蕈碱药物的安全性。足够的证据表明,在综合考虑疗效和不良反应,成本效益以及依从性和持久性方面,ER制剂优于IR制剂。
关键词: 抗毒蕈碱,抗胆碱能药物,系统评价,Meta分析。
图形摘要
Current Drug Targets
Title:Antimuscarinics in the Treatment of OAB: Is there a First-Line and a Second-Line Choice?
Volume: 16 Issue: 11
Author(s): Apostolos Apostolidis
Affiliation:
关键词: 抗毒蕈碱,抗胆碱能药物,系统评价,Meta分析。
摘要: Antimuscarinics are currently the mainstay of pharmacotherapy of the overactive bladder (OAB) syndrome. Several meta-analyses have confirmed their efficacy in comparison with placebo, although the clinical significance of differences in parameters recorded in clinical trials has been questioned. Trials examining the effect of antimuscarinics on outcomes which matter to the patients, such as subjective cure/improvement rates, quality of life parameters and cost-effectiveness are relatively limited. Also, comparative studies between the various available drugs have been designed to support the registration requirements and rarely provide information critical for a physician who needs to assess the best first-line choice for the specific patient, or even a second-line management. Data which might be useful for clinicians who would embark on tailoring the management of OAB for the individual patient could be found in systematic reviews/meta-analyses, cost-effectiveness studies and studies investigating the patients’ adherence to treatment and persistence with pharmacotherapy for OAB. In addition, patient co-morbidities and concurrent treatments should be taken into consideration in conjunction with the safety profile of each antimuscarinic. Available evidence suggests that the use of ER formulations of antimuscarinics is favoured over the IR formulations when concerning best balance between efficacy and adverse events, cost-effectiveness, adherence and persistence with treatment.
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Cite this article as:
Apostolos Apostolidis , Antimuscarinics in the Treatment of OAB: Is there a First-Line and a Second-Line Choice?, Current Drug Targets 2015; 16 (11) . https://dx.doi.org/10.2174/1389450116666150518102021
DOI https://dx.doi.org/10.2174/1389450116666150518102021 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
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