| 제목 |
Long-term efficacy of mirabegron add-on therapy to antimuscarinic agents in patients with SCI |
| 소속 |
National Rehabilitation Center, Department of Rehabilitation Medicine1, Hanyang University Medical Center, Department of Rehabilitation Medicine2 |
| 저자 |
Seok Hee Han1,1*, Bum-Suk Lee1,1†, Seong Ho Jang2,2, Joo Hwan Jung1,1, In Kyoung Cho1,1 |
Study design: Retrospective chart analysis.
Objectives: To evaluate the long-term efficacy of mirabegron add-on therapy in patients with spinal cord injury based on urodynamic study (UDS).
Methods: The study included patients with SCI who underwent two consecutive UDS between April 1, 2015 and April 1, 2018. After adding 50 mg of mirabegron once a day to pre-existing antimuscarinic agents for a period of at least 6 months, the following variables were analyzed: change in cystometric capacity (ml), change in bladder compliance (ml/cm H2O), change in maximal detrusor pressure (cm H2O), change in reflex volume (ml) and presence of significant leakage during filling cystometry.
Results: A total of 31 patients with a mean age of 40.61 years (SD ± 14.50) were included in the analysis. Significant increase in cystometric capacity (mean, 362.32 to 423.65 ml, P = 0.026), reflex volume (mean, 251.23 to 328.55 ml, P = 0.018) and bladder compliance (median, 11.80 to 17.50 ml/cm H2O , P = 0.039) were observed. The presence of leakage during filling CMG were also significantly reduced (29.0% to 9.7%, P = 0.031). The change in maximal detrusor pressure decreased from mean of 31.48 to 27.48 cm H2O, but did not reach statistical significance (P = 0.385).
Conclusion: Adding mirabegron to conventional AMs further improved urodynamic parameters in chronic SCI patients and the efficacy sustained in long term use.
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Table 1 Characteristics of the participants, N=31 Abbreviation : SD, standard deviation; NLI, neurological level of injury; AIS, ASIA(American Spinal Injury Association) Impairment Scale; CIC, clean intermittent catheterization; IQR, interquartile range
Figure 1 Change in cystometric capacity, reflex volume, maximal detrusor pressure and leakage during CMG after adding mirabegron 50mg a day in SCI patients. * P < 0.05
Figure 2 Box plots of compliance (ml/cm H2O) before and after adding mirabegron 50mg a day in SCI patients. * P < 0.05
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