Simplified bladder training augments the effectiveness of tolterodine in patients with an overactive bladder
Simplified bladder training augments the effectiveness of tolterodine in patients with an overactive bladder
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DOI：
10.1046/j.1464-410x.2003.03076.x
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发表时间：
2003-01-01
影响因子：
4.5
通讯作者：
Wein, AJ
中科院分区：
文献类型：
--
作者：
Mattiasson, A;Blaakaer, J;Wein, AJ
目的 比较托特罗定联合简化膀胱训练 (BT) 与单用托特罗定治疗膀胱过度活动症患者的疗效。 患者和方法 在 51 个斯堪的纳维亚中心的一项多中心、单盲研究中，505 名年龄大于或等于 18 岁、有尿频症状（大于或等于 8 次排尿/24 小时）和尿急（有或没有尿急）的患者 失禁患者被随机接受口服托特罗定 2 mg 每日两次加简化 BT 治疗或单独接受托特罗定治疗。治疗 2、12 和 24 周后评估排尿日记变量的变化。还确定了患者对其膀胱症状和耐受性（不良事件）的看法。 结果总共有 501 名患者（75% 女性）在意向治疗基础上进行了评估（244 名患者接受托特罗定 + BT 治疗，257 名患者接受单独托特罗定治疗）。托特罗定显着降低了所有采样时间的排尿频率并增加了每次排尿的体积；通过添加 BT，这些效果显着增强。研究结束时，托特罗定 + BT 组的排尿频率中位百分比降低幅度大于托特罗定单用组（33% vs 25%，P < 0.001），而托特罗定 + BT 组每次排尿量的中位百分比增加量为 31%，托特罗定单用组为 20%（P < 0.001）。与单独使用托特罗定的基线相比，失禁发作次数中位数减少了 81%，这与托特罗定 + BT 组 (- 87%) 没有显着差异。两组的紧急情况减少百分比中值相当。大约 76% 接受托特罗定 + BT 治疗的患者报告其膀胱症状相对于基线有所改善，而单独使用托特罗定的患者这一比例为 71%。托特罗定耐受性良好；最常见的不良事件是轻度口干。 结论 托特罗定 2 mg 每日两次是治疗膀胱过度活动症的有效且耐受性良好的治疗方法，简化的 BT 方案可增强其疗效。
OBJECTIVESTo compare the efficacy of tolterodine plus simplified bladder training (BT) with tolterodine alone in patients with an overactive bladder.PATIENTS AND METHODSIn a multicentre, single-blind study at 51 Scandinavian centres, 505 patients aged greater than or equal to 18 years with symptoms of urinary frequency (greater than or equal to 8 micturitions/24 h) and urgency, with or without urge incontinence, were randomized to oral treatment with either tolterodine 2 mg twice daily plus simplified BT or tolterodine alone. Changes in voiding diary variables were evaluated after 2, 12 and 24 weeks of treatment. The patients' perceptions of their bladder symptoms and tolerability (adverse events) were also determined.RESULTSIn all, 501 patients (75% women) were evaluable on an intention-to-treat basis (244 on tolterodine + BT and 257 on tolterodine alone). Tolterodine significantly reduced the voiding frequency and increased the volume voided per void at all sample times; these effects were significantly increased by adding BT. At the end of the study the median percentage reduction in voiding frequency was greater with tolterodine + BT than with tolterodine alone (33% vs 25%, P < 0.001), while the median percentage increase in volume voided per void was 31% with tolterodine + BT and 20% with tolterodine alone (P < 0.001). There was a median of 81% fewer incontinence episodes than at baseline with tolterodine alone, which was not significantly different from that with tolterodine + BT (- 87%). The two groups had comparable median percentage reductions in urgency episodes. Some 76% of patients on tolterodine + BT reported an improvement in their bladder symptoms relative to baseline, compared with 71% on tolterodine alone. Tolterodine was well tolerated; the most common adverse event was mild dry mouth.CONCLUSIONTolterodine 2 mg twice daily is an effective and well tolerated treatment for an overactive bladder, the effectiveness of which can be augmented by a simplified BT regimen.