This nonsystematic review provides a summary of current evidence on the use of β3-adrenoreceptor agonists (β3-ARAs) for the treatment for lower urinary tract symptoms. Soon after their discovery in 1989, β3-ARs were identified as a predominant adrenoreceptor subtype in the human urinary bladder. Although it is widely believed that β3-ARAs cause detrusor relaxation, the effect on bladder afferent signaling likely plays an important role in their mechanism of action as well. In 2011 and 2012, mirabegron was approved for clinical use in overactive bladder (OAB) patients. Pooled analysis of data from prospective randomized studies on >60,000 OAB patients showed that when compared to placebo, mirabegron was superior with respect to reducing the frequency, number, and severity of urgency episodes, number of incontinence episodes and increasing dry rate, but not in reduction of nocturia episodes. The only side effect showing significantly higher incidence than placebo was nasopharyngitis. Mirabegron is approved for OAB treatment in all age-groups and in pediatric patients with neurogenic bladder. Vibegron is another β3-ARA approved for OAB treatment in the US and Japan. Several large, multicenter, double-blind, randomized trials have documented statistically significant superiority of vibegron over placebo on all efficacy end points. Other β3-ARAs are being developed; however, to date none has been introduced to clinical use. All β3-ARAs provide efficacy similar to anticholinergics. They have a favorable safety profile and are well tolerated. Due to their different mechanisms of action, combination of β3-ARAs with anticholinergic compounds allows for increased efficacy.
- Klíčová slova
- beta-mimetics, efficacy, mirabegron, safety, urinary bladder, vibegron,
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
INTRODUCTION AND HYPOTHESIS: The objective was to evaluate the intra-individual variability of uroflowmetry (UFM) in healthy control subjects and women suffering from stress, urge, and mixed urinary incontinence. METHODS: A total of 35 healthy controls (group A) and 105 women suffering from urinary incontinence were enrolled in the study. Thirty-five women suffered from stress urinary incontinence (group B), 35 women suffered from mixed urinary incontinence (group C), and 35 women with overactive bladder both dry and wet (group D). All participants were asked to perform UFM measurement three times. The following parameters were analyzed: voided volume (VV), peak flow (Qmax), average flow (Qave), volume-corrected peak flow cQmax (cQmax = Qmax/2√ VV), volume-corrected average flow (cQave = Qave/2√ VV), and postvoid residual volume (PVR). Statistical analysis was performed using the analysis of variance on repeated measurements. Relative error was calculated using variation coefficients reported as a percentage of the average. All descriptive characteristics were reported as means ± standard deviation (SD). p values ≤0.05 were considered statistically significant. RESULTS: No statistically significant intra-individual difference in any of the recorded parameters was identified among the three UFM recordings in groups A, C, and D. The intra-individual variability of the following parameters reached statistical significance in patients suffering from stress urinary incontinence (group B): Qmax (p = 0.0016), Qave (p = 0.0005), and cQave (p = 0.0389). A significant difference was only observed in comparison between the first and second consecutive recordings. CONCLUSIONS: This study provides evidence supporting the high yield and good intra-individual reproducibility of UFM.
- Klíčová slova
- Lower urinary tract symptoms, Uroflowmetry, Variability, Voiding pattern,
- MeSH
- dospělí MeSH
- hyperaktivní močový měchýř patofyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- reologie metody statistika a číselné údaje MeSH
- reprodukovatelnost výsledků MeSH
- stresová inkontinence moči patofyziologie MeSH
- studie případů a kontrol MeSH
- urgentní inkontinence patofyziologie MeSH
- urodynamika fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH