Comparison of the efficacy, safety, and tolerability of propiverine and oxybutynin for the treatment of overactive bladder syndrome
Comparison of the efficacy, safety, and tolerability of propiverine and oxybutynin for the treatment of overactive bladder syndrome
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丙哌维林和奥昔布宁治疗膀胱过度活动综合征的疗效、安全性和耐受性比较
DOI：
10.1111/j.1442-2042.2007.01752.x
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发表时间：
2007
影响因子：
2.6
通讯作者：
Werner Schaefer
中科院分区：
文献类型：
--
作者：
Werner Schaefer
目的： 比较丙哌维林和奥昔布宁对膀胱过度活动症患者动态尿动力学监测 (AUM) 参数、安全性和耐受性的影响。
方法： 这是一项随机、双盲、安慰剂对照、多中心、交叉研究。患者 (n = 77) 在两个为期 2 周的周期内接受以下两种治疗：丙哌维林 20 mg，每日一次，丙哌维林 15 mg，每日 3 次，奥昔布宁 5 mg，每日 3 次，以及安慰剂。评估 AUM 参数、唾液流量、视觉近点和心率。
结果： 在平均不自主逼尿肌收缩减少方面，观察到积极治疗组之间的疗效顺序一致（IDC；奥昔布宁 15 mg ≤ 丙哌维林 45 mg ≤ 丙哌维林 20 mg）。奥昔布宁和丙哌维林 20 mg 组之间的多个 AUM 终点差异具有统计学意义。奥昔布宁组和两个丙哌维林组之间在唾液流量和心率（奥昔布宁 15 mg < 两种丙哌维林治疗方案）和心率变异性（两种丙哌维林治疗方案 < 奥昔布宁 15 mg）方面也存在显着统计学差异。所有积极的治疗都延长了近视点。奥昔布宁组口干的发生率明显高于丙哌维林组。 45 毫克丙哌维林治疗导致便秘、近视点延长以及对心率的影响最高。
结论： 奥昔布宁 15 mg 在减少门诊患者有症状和无症状 IDC 方面比丙哌维林 20 mg 更有效。两种药物之间的主要区别在于不良事件的发生率和类型，其随每种药物的抗毒蕈碱受体特异性而变化。
Aim: To compare the effects of propiverine and oxybutynin on ambulatory urodynamic monitoring (AUM) parameters, safety, and tolerability in patients with overactive bladder.
Methods: This was a randomized, double-blind, placebo-controlled, multicentre, crossover study. Patients (n = 77) received two of the following treatments during two 2-week periods: propiverine 20 mg once daily, propiverine 15 mg three times daily, oxybutynin 5 mg three times daily, and placebo. AUM parameters, salivary flow, visual near point, and heart rate were assessed.
Results: A consistent order in the efficacy between active treatment groups was observed for the reduction in mean involuntary detrusor contractions (IDCs; oxybutynin 15 mg ≤ propiverine 45 mg ≤ propiverine 20 mg). Differences between the oxybutynin and propiverine 20 mg groups were statistically significant for several AUM endpoints. Statistically significant differences between the oxybutynin and both propiverine groups were also noted in salivary flow rate and heart rate (oxybutynin 15 mg < both propiverine regimens) and in heart rate variability (both propiverine regimens < oxybutynin 15 mg). All active treatments lengthened visual near point. The incidence of dry mouth was significantly more pronounced in the oxybutynin group than in either propiverine group. Treatment with propiverine 45 mg resulted in the highest rates of constipation, lengthening of the visual near point, and effects on heart rate.
Conclusions: Oxybutynin 15 mg was more effective than propiverine 20 mg in reducing symptomatic and asymptomatic IDCs in ambulatory patients. The primary differences between the two drugs were the incidence and type of adverse events, which varied with the antimuscarinic receptor specificity of each agent.