什么是最好的第一选择口服药物治疗OAB?
Arun Sahai1, Dudley Robinson2, Paul Abrams3,4
1Department of Urology, Guy's Hospital & King's College, London, UK.
Neurourology and urodynamics
|January 25, 2024
概括
由于目前口服药物的担忧,过活性膀 (OAB) 的管理正在转向个性化治疗. 新证据表明,抗肌肉类药物和β3激动剂具有局限性,促使人们转向个性化OAB治疗.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 药理学 药理学是指药理学的学科.
- 老年学是一门学科.
背景情况:
- 过度活性膀 (OAB) 管理通常以保守的措施开始,如膀训练.
- 口服药物治疗,主要是抗肌肉类药物和β3激动剂,是症状患者的下一步.
- 不断变化的证据和药物安全性概况正在重塑一线OAB治疗策略.
研究的目的:
- 在ICI-RS2023会议上提出的OAB治疗的最新讨论和不断发展的概念的总结.
- 根据新的证据和不良事件概况,突出显示OAB管理策略的转变.
- 探索过度活动膀个性化治疗的概念.
主要方法:
- 在2023年ICI-RS会议上进行讨论和辩论.
- 总结了所提出的概念和互动讨论.
- 对OAB药物的最新证据和不良事件概况的审查.
主要成果:
- OAB的指导方针越来越倾向于针对患者因素量身定制的抗肌肉素或β3激动剂方法.
- 人们对抗肌肉类药物的长期影响存在担忧,包括认知,心血管和死亡风险.
- 抗肌肉素和β3激动剂治疗均表现出较低的长期坚持和持久率,并存在处方障碍.
结论:
- 目前用于OAB的口服药物治疗受到不良事件和坚持问题的限制.
- 虽然有效,但抗类药物和β3激动剂在临床试验中显示出显著的安慰剂效应.
- 个性化治疗方法,考虑到个体的病因因素和表型,代表了OAB管理的逻辑进步.
相关概念视频
Drugs for Treatment of Diarrhea-Predominant IBS
175
Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
175
Drugs for Treatment of Constipation-Predominant IBS
169
Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
169
Parkinson's Disease: Treatment
268
Neurodegenerative disorders, such as Parkinson's Disease (PD), involve the gradual and irreversible destruction of neurons in particular brain areas. These disorders exhibit standard features like proteinopathies, selective vulnerability of some neurons, and an interaction of intrinsic properties, genetics, and environmental influences in neural injury.
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of...
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of...
268
Cholinergic Antagonists: Therapeutic Uses
749
Antimuscarinic drugs have various therapeutic applications by inhibiting parasympathetic stimulation in different systems. Here are the key therapeutic uses of antimuscarinics:
Respiratory Tract: Ipratropium, aclidinium, and tiotropium treat asthma, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). They protect against bronchoconstriction caused by irritants like cigarette smoke, sulfur dioxide, and ozone. They also help reduce nasopharyngeal...
Respiratory Tract: Ipratropium, aclidinium, and tiotropium treat asthma, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). They protect against bronchoconstriction caused by irritants like cigarette smoke, sulfur dioxide, and ozone. They also help reduce nasopharyngeal...
749
Drugs Affecting GI Tract Motility: Dopamine Receptor Antagonists
323
Prokinetic agents are specialized medications that stimulate gastrointestinal (GI) motility, promoting food movement through the GI tract. Dopamine, an inhibitory neurotransmitter, plays a significant role in this process, reducing GI motility and indirectly controlling the speed of digestion. Dopamine receptor antagonists, such as metoclopramide and domperidone, offer a unique advantage as prokinetic agents. By blocking the dopamine receptors, these drugs increase GI motility, improving food...
323
Direct-Acting Cholinergic Agonists: Therapeutic Uses
744
Direct-acting cholinergic agonists have many therapeutic uses in various medical fields. Choline esters, including acetylcholine, have limited clinical utility due to their non-selectivity and short duration of action. Still, acetylcholine and carbachol are applied topically during ophthalmologic surgery to induce miosis. Pilocarpine, a muscarinic and ganglionic stimulator, effectively treats open-angle glaucoma and alleviates xerostomia and dry mouth caused by radiotherapy or Sjögren...
744


