治疗帕金森病患者膀胱过度活动症的药物疗效和安全性：一项随机、双盲、安慰剂对照试验的荟萃分析和系统评价。
The efficacy and safety of medication for treating overactive bladder in patients with Parkinson's disease: a meta-analysis and systematic review of randomized double-blind placebo-controlled trials.
机构信息
Department of Urology, Tengzhou Central People's Hospital, Tengzhou, 277500, China.
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100070, China.
出版信息
Int Urogynecol J. 2023 Sep;34(9):2207-2216. doi: 10.1007/s00192-023-05528-y. Epub 2023 Apr 13.
INTRODUCTION AND HYPOTHESIS
The goal of this meta-analysis was to determine the efficacy and safety of medication for treating overactive bladder (OAB) in patients with Parkinson's disease (PD).
METHODS
Papers containing predefined key terms were searched in the PubMed, Embase, Web of Science, and Cochrane Library databases up to December 2021 to collect randomized double-blind placebo-controlled trials (RCTs). The review process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements. Two reviewers independently assessed the risk of bias using the modified Jadad scale and Cochrane risk-of-bias tool. The GRADEpro GDT was employed to evaluate the strength of evidence based on the findings of this meta-analysis.
RESULTS
We eventually included four RCTs involving 313 patients (163 patients in the medication group and 150 patients in the placebo group). Of these, the therapeutic agent in two RCTs was mirabegron (121 and 106 patients and controls, respectively, representing 3/4 -2/3 of the patients). The results showed that the number of micturition episodes per 24 h (MD -1.33; 95% CI -2.30 to -0.36; p = 0.007), the number of nocturia episodes per 24 h (MD -0.33; 95% CI -0.58 to -0.08; p = 0.009) and the number of urinary incontinence episodes per 24 h (MD -0.72; 95% CI -1.32 to -0.12; p = 0.02) were significantly lower in the medication group than in the placebo group. The OAB symptom score (MD -2.84; 95% CI -4.67 to -1.00; p = 0.002) and quality of life score (MD 15.15; 95% CI 12.33 to 17.96; p < 0.0001) of the medication group were significantly improved compared with those of the placebo group. However, no significant difference in the daily frequency of urinary urgency episodes was identified between the medication group and the placebo group (MD -0.79; 95% CI -1.71 to 0.14; p = 0.09). There were no significant differences between the two groups in terms of drug-related adverse events (OR 1.69; 95% CI 0.41 to 6.99; p = 0.47), especially in PD patients receiving mirabegron therapy.
CONCLUSIONS
Medication was effective for OAB symptoms in patients with PD, and patients tolerated adverse events well.
简介和假设
本荟萃分析的目的是确定治疗帕金森病（PD）患者膀胱过度活动症（OAB）的药物的疗效和安全性。
方法
截至 2021 年 12 月，我们在 PubMed、Embase、Web of Science 和 Cochrane Library 数据库中搜索了包含预定义关键词的论文，以收集随机双盲安慰剂对照试验（RCT）。审查过程遵循系统评价和荟萃分析的首选报告项目（PRISMA）声明。两位审查员使用改良 Jadad 量表和 Cochrane 风险偏倚工具独立评估偏倚风险。GRADEpro GDT 用于根据本荟萃分析的结果评估证据强度。
结果
我们最终纳入了四项 RCT，涉及 313 名患者（药物组 163 名，安慰剂组 150 名）。其中，两项 RCT 的治疗药物分别为米拉贝隆（药物组分别为 121 名和 106 名患者和对照组，占患者人数的 3/4-2/3）。结果显示，药物组 24 小时排尿次数（MD -1.33；95%CI -2.30 至 -0.36；p=0.007）、夜间排尿次数（MD -0.33；95%CI -0.58 至 -0.08；p=0.009）和 24 小时尿失禁次数（MD -0.72；95%CI -1.32 至 -0.12；p=0.02）均显著低于安慰剂组。药物组 OAB 症状评分（MD -2.84；95%CI -4.67 至 -1.00；p=0.002）和生活质量评分（MD 15.15；95%CI 12.33 至 17.96；p<0.0001）均显著优于安慰剂组。然而，药物组与安慰剂组在每日尿急发作频率方面无显著差异（MD -0.79；95%CI -1.71 至 0.14；p=0.09）。两组药物相关不良反应（OR 1.69；95%CI 0.41 至 6.99；p=0.47）无显著差异，尤其是接受米拉贝隆治疗的 PD 患者。
结论
药物治疗对 PD 患者的 OAB 症状有效，且患者能耐受不良反应。
Zotero 插件