|許竣凱||幼兒使用Mirabegron 治療膀胱過動的療效評估-回溯性研究||2020/6/30 下午 04:01:11||0|
|原 文||題 目||Effectiveness and tolerability of mirabegron in children with overactive bladder: A retrospective pilot study|
|作 者||Samantha Fryer 1, Cezar Nicoara 1, Emily Dobson 1, Megan Griffiths 1, H Fiona McAndrew 1, Simon E Kenny 2, Harriet J Corbett 3|
|出 處||Journal of Pediatric Surgery|
mirabegron 已經廣泛用於成人的膀胱過動症，但缺少用於兒童時的安全性及成效報告。作者回顧2014年二月到2018年11月，因其他抗乙烯膽鹼藥物無效而不得不使用mirabegron的兒童的治療成效及過程。在該期間共有70個兒童接受mirabegron治療，當中50個是女性，年齡中位數為15歲，53%的個案持續使用超過6個月，單用mirabegron 的個案中，35%尿床改善，58%日間尿失禁改善，60%頻尿改善。而需要併用其他藥物治療的個案改善的機會都較單用mirabegron的個案低。會停藥的主因，40%是因為沒有效果，其他共7人出現頭痛、口乾、頭暈的副作用，有4人甚至膀胱過動的症狀變嚴重。
Aims: Mirabegron has promising results for OAB symptoms in adults, although the potential for cardiovascular side effects has caused concern. Efficacy and tolerability in children have not been extensively studied. Effectiveness, tolerability, and side effects of Mirabegron are reported in children with refractory OAB.
Methods: A retrospective review of children receiving Mirabegron between February 2014 and November 2018 was completed. Frequency, urgency, nocturnal (NE), and daytime incontinence (DI) were analyzed at baseline and 6 months.
Results: 70 children (50 females), median age 15 [range 8-16] years, commenced Mirabegron 25 mg (n = 29) or 50 mg (n = 41). 37 (53%) were still receiving treatment at 6 months: monotherapy n = 30, and combination therapy n = 7 (Solifenacin n = 4, Desmopressin n = 2, both n = 1). Where undertaken, blood pressure monitoring and ECGs were normal. For patients on monotherapy, 6 of 17 (35%) had improvement in NE, 11 of 19 (58%) in DI, 12 of 20 (60%) in frequency, and 8 of 21 (38%) in urgency symptoms. For patients receiving combination therapy, 2 of 6 (33%) had improvement in NE, 2 of 4 in DI (50%), 2 of 4 (50%) in frequency, and 4 of 6 (67%) had improvement in urgency. Reasons for treatment discontinuation (entire cohort) were: ineffectiveness (n = 28), worse symptoms (n = 4) and/or adverse reactions (n = 7), including dry mouth (n = 2), headaches (n = 4), dizziness (n = 1), nausea/vomiting (n = 3), increased seizures (n = 1), and rash (n = 1).
Conclusion: Mirabegron improved symptoms in 70% of patients with refractory OAB. A prospective RCT should be the next step to establish the role of Mirabegron for the treatment of OAB in children.