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蔡佳宏 兩年期 OASIS 標誌性研究:使用 Revi 系統治療急迫性尿失禁的療效與安全性結果 2025/2/26 下午 03:52:39 0
原 文 題  目 Two-Year Efficacy and Safety Outcomes of the Pivotal OASIS Study Using the Revi System for Treatment of Urgency Urinary Incontinence
作  者 John P. F. A. Heesakkers, Philip Toozs-Hobson, Suzette E. Sutherland, Alex Digesu, Cindy L. Amundsen, Rebecca J. McCrery, Stefan De Wachter, Emily R. Kean, Frank Martens, Kevin Benson, Kimberly L. Ferrante, Kevin J. Cline, Osvaldo F. Padron, Laura Giusto, Felicia L. Lane, Lambertus P. W. Witte, and Roger R. Dmochowski
出  處 J Urol. 2025 Mar;213(3):323-332. doi: 10.1097/JU.0000000000004328.Epub 2024 Nov 25.
出版日期 01 March 2025
評 論 神經調控治療(neuromodulation)是膀胱過動症的一種治療,此篇文章提及的Revi裝置,是一種植入式的脛神經調控治療裝置,而這樣的裝置會透過外部穿戴式設備進行激活,透過這樣的裝置可以治療急迫性尿失禁(濕式膀胱過動症,OAB wet)。OASIS 研究評估 Revi 系統作為植入式脛神經調控技術的長期療效與安全性,研究共納入 151 名女性受試者,並進行 2 年追蹤。結果顯示,79%(77/97)患者急迫性尿失禁發作次數減少 ≥50%,其中 56% 減少 ≥75%。此外,97% 受試者對治療感到滿意,96.9% 認為症狀明顯改善,顯示 Revi 系統在改善患者生活品質方面具有顯著成效。在安全性方面,研究未發現裝置或手術相關的嚴重不良事件(SAEs),裝置移除率僅 2%。Revi 系統的優勢在於無需內建電池,避免更換手術,患者可在家中自行進行治療,減少對門診治療的依賴,且療效穩定持續,6、12、24 個月治療的效果分別為 78%、82%、79%。本研究結果證明,Revi 系統提供了一種有效且安全的微創神經調控治療選擇,特別適用於無法耐受或不適合傳統藥物治療的急迫性尿失禁的患者,並符合 2024 年 AUA/SUFU 指南對於微創治療的建議,為臨床治療提供新的選擇。
abstract

Purpose: The BlueWind Medical Device, Revi, is a novel implantable tibial neuromodulation system powered by an external, battery-operated wearable that facilitates individually tailored stimulation to provide treatment for urgency urinary incontinence (ie, overactive bladder wet). The Revi System is the first Food and Drug Administration-cleared implantable neuromodulation device which can be used without prior failure with more conservative treatment options. Two-year follow-up results of the OASIS (Overactive Bladder Stimulation System) study are presented.

Materials and methods: The Revi System was implanted in 151 female participants. The primary efficacy and safety end points were assessed at 6 and 12 months, after which participants either consented to extend follow-up for long-term assessment of treatment durability and safety or they chose to exit the study.

Results: Ninety-seven participants completed the 24-month assessment, and of these, 79% were therapy responders (≥50% reduction in urgency urinary incontinence episodes, demonstrated on a 3-day voiding diary). Importantly, therapeutic response was durable, with comparable effectiveness at 6, 12, and 24 months (response rates of 78%, 82%, and 79%, respectively). Participants who completed both the 6- and 24-month assessment had similar demographics and treatment results at the 6-month visit, indicating that these results at 24 months are representative of the overall study population. In addition, high satisfaction and patient impression of improvement were reported, with 97% (88/91) of the participants satisfied with the therapy and 80% (78/97) feeling "much better" or "very much better." There were no serious adverse events related to the device or the procedure through 24 months.

Conclusions: Two-year results demonstrate durable efficacy, high patient satisfaction, and a very favorable safety profile.

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