Real-world persistence and adherence to oral antimuscarinics and mirabegron in patients with overactive bladder (OAB): a systematic literature review.
Real-world persistence and adherence to oral antimuscarinics and mirabegron in patients with overactive bladder (OAB): a systematic literature review.
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DOI：
10.1136/bmjopen-2018-021889
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发表时间：
2018-11-21
期刊：
影响因子：
2.9
通讯作者：
Fatoye F
中科院分区：
文献类型：
--
作者：
Yeowell G;Smith P;Nazir J;Hakimi Z;Siddiqui E;Fatoye F
评估在现实世界中口服药物治疗膀胱过动症（OAB）的持久性和依从性。对6个电子出版物数据库进行系统的文献检索，以确定抗毒菌素和/或米拉贝隆治疗OAB患者的观察性研究。从电子处方声明以外的来源获得持久性和依从性数据的研究被排除在外。评估已确定研究的参考文献清单和相关的系统评价，以确定其他相关研究。该研究确定了3897项研究，其中30项被纳入。总的来说，持久性在5%到47%之间。在报告抗毒菌素和mirabegron （n=3）数据的研究中，1年的持久性分别为12%-25%和32%-38%。抗uscarinics的中位停药时间<5个月（除了一项研究（6.5个月）），mirabegron的中位停药时间为5.6-7.4个月。1年坚持治疗的患者比例在15%到44%之间变化。在报告抗毒菌素和米拉贝隆依从性的研究中，米拉贝隆的依从性更高(平均药物占有比（MPR）： 0.59 vs 0.41-0.53；覆盖天数的平均比例：0.66 vs 0.55；中位MPR: 0.65 vs 0.19-0.49)。报告的持久性和依从性的决定因素包括女性（性别），年龄较大的群体，使用缓释制剂和治疗经验。大多数OAB患者停止口服OAB药物治疗，并在治疗开始1年后无依从性。总的来说，与抗毒蕈素相比，mirabegron具有更强的持久性和依从性。结合现有的临床试验证据，这一现实世界的回顾值得考虑将米拉贝隆作为OAB患者的一线药物治疗。CRD42017059894。
To evaluate persistence and adherence of oral pharmacotherapy used in the treatment of overactive bladder (OAB) in a real-world setting. Systematic literature searches of six electronic publication databases were performed to identify observational studies of patients with OAB treated with antimuscarinics and/or mirabegron. Studies obtaining persistence and adherence data from sources other than electronic prescription claims were excluded. Reference lists of identified studies and relevant systematic reviews were assessed to identify additional relevant studies. The search identified 3897 studies, of which 30 were included. Overall, persistence ranged from 5% to 47%. In studies reporting data for antimuscarinics and mirabegron (n=3), 1-year persistence was 12%–25% and 32%–38%, respectively. Median time to discontinuation was <5 months for antimuscarinics (except one study (6.5 months)) and 5.6–7.4 months for mirabegron. The proportion of patients adherent at 1 year varied between 15% and 44%. In studies reporting adherence for antimuscarinics and mirabegron, adherence was higher with mirabegron (mean medication possession ratio (MPR): 0.59 vs 0.41–0.53; mean proportion of days covered: 0.66 vs 0.55; and median MPR: 0.65 vs 0.19–0.49). Reported determinants of persistence and adherence included female (sex), older age group, use of extended-release formulation and treatment experience. Most patients with OAB discontinued oral OAB pharmacotherapy and were non-adherent 1 year after treatment initiation. In general, mirabegron was associated with greater persistence and adherence compared with antimuscarinics. Combined with existing clinical trial evidence, this real-world review merits consideration of mirabegron for first-line pharmacological treatment among patients with OAB. CRD42017059894.
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