药物治疗过活性膀综合征和发生痴呆症的风险
David Sheyn1, Jennifer Murphy2, Abhimanyu Mahajan3
1Urology Institute, University Hospitals, Cleveland, OH, USA. David.d.sheyn@gmail.com.
World journal of urology
|April 4, 2025
概括
大多数抗胆固醇药物和mirabegron在过度活性膀患者中增加痴呆风险. 与未接受治疗的个人相比,费索特罗丁没有增加痴呆症风险.
科学领域:
- 老年学是一门学科.
- 药理学 药理学是指药理学的学科.
- 神经学 神经学
背景情况:
- 过度活性膀 (OAB) 药物治疗包括抗胆固醇药物和mirabegron.
- 对于这些OAB治疗的潜在神经认知副作用存在担忧.
研究的目的:
- 为了比较患者处方抗胆固醇药物与mirabegron之间发生痴呆症的风险.
- 为了评估与特定抗胆固醇药物相关的痴呆风险,根据风险水平分层分层.
主要方法:
- 使用TrinetX研究协作网络进行的回顾性队列研究 (2012-2023年).
- 包括治疗OAB的患者,使用mirabegron,特定抗胆固醇药物 (高风险:oxybutynin,tolterodine,solifenacin;低风险:darifenacin, trospium, fesoterodine),或没有药物 (控制).
- 根据年龄,性别,Elixhauser并发症指数和抗胆固醇负担得分进行调整的Cox比例危险分析.
主要成果:
- 分析包括941,402名患者,其中83,550人接受药物治疗,平均随访时间为4.3年.
- 在所有人口统计数据中,Mirabegron与痴呆症风险增加有显著关联.
- 费索特罗丁是唯一不与痴呆症风险增加相关的药物;大多数其他抗胆固醇药也显示风险增加.
结论:
- 与未经治疗的OAB患者相比,mirabegron和大多数抗胆固醇药物都与更高的痴呆发病率有关.
- 在OAB药物治疗中,Fesoterodine似乎是关于痴呆风险的更安全的选择.
- 需要进一步研究OAB药物的长期神经认知影响.
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