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Funada S, Luo Y, Uozumi R, Watanabe N, Goto T, Negoro H, Ueno K, Ichioka K, Segawa T, Akechi T, Ogawa O, Akamatsu S, Kobayashi T, Furukawa TA. Multicomponent Intervention for Overactive Bladder in Women: A Randomized Clinical Trial. JAMA Netw Open 2024; 7:e241784. [PMID: 38477920 PMCID: PMC10938174 DOI: 10.1001/jamanetworkopen.2024.1784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 01/19/2024] [Indexed: 03/14/2024] Open
Abstract
Importance Although the cognitive components of behavioral therapy for overactive bladder (OAB) are widely recognized, there is a lack of studies evaluating the effectiveness of multicomponent interventions that include cognitive components as a treatment for OAB. Objective To examine the efficacy of a multicomponent intervention in improving health-related quality of life (HRQOL) for women with moderate to severe OAB. Design, Setting, and Participants This multicenter, open-label, randomized clinical trial was conducted in Japan among women aged 20 to 80 years who had moderate to severe OAB. Participants were recruited from 4 institutions between January 16, 2020, and December 31, 2022, through self-referral via advertisement or referral from the participating institutions. Interventions Participants were randomized 1:1 by minimization algorithm using an internet-based central cloud system to four 30-minute weekly sessions of a multicomponent intervention or waiting list. Both groups continued to receive baseline treatment throughout the study period. Main Outcomes and Measures The primary outcome was the least-squares mean changes from baseline through week 13 in HRQOL total scores of the OAB questionnaire between 2 groups. Secondary outcomes included OAB symptom score and frequency volume chart. Results A total of 79 women were randomized to either the intervention group (39 participants; mean [SD] age, 63.5 [14.6] years) or the waiting list control group (40 participants; mean [SD] age, 63.5 [12.9] years). One participant from each group dropped out from the allocated intervention, while 5 participants in the intervention group and 2 in the control group dropped out from the primary outcome assessment at week 13. Thirty-six participants (92.3%) in the intervention group and 35 (87.5%) in the control group had moderate OAB. The change in HRQOL total score from baseline to week 13 was 23.9 points (95% CI, 18.4-29.5 points) in the intervention group and 11.3 points (95% CI, 6.2-16.4 points) in the waiting list group, a significant difference of 12.6 points (95% CI, 6.6-18.6 points; P < .001). Similar superiority of the intervention was confirmed for frequency of micturition and urgency but not for OAB symptom score. Conclusions and Relevance These findings demonstrate that a multicomponent intervention improves HRQOL for women with moderate to severe OAB and suggest that the cognitive component may be an effective treatment option for women with OAB. Trial Registration UMIN Clinical Trials Registry Identifier: UMIN000038513.
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Affiliation(s)
- Satoshi Funada
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Health Promotion and Human Behavior, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Yan Luo
- Department of Health Promotion and Human Behavior, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryuji Uozumi
- Department of Industrial Engineering and Economics, Tokyo Institute of Technology, Tokyo, Japan
| | - Norio Watanabe
- Department of Psychiatry, Soseikai General Hospital, Kyoto, Japan
| | - Takayuki Goto
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiromitsu Negoro
- Department of Urology, Institute of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Kentaro Ueno
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | | | | - Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Osamu Ogawa
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shusuke Akamatsu
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takashi Kobayashi
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Toshi A. Furukawa
- Department of Health Promotion and Human Behavior, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Herschorn S, Tarcan T, Jiang YH, Chung E, Abdul Hadi F, Steup A, Sumarsono B. Safety and efficacy of an α 1 -blocker plus mirabegron compared with an α 1 -blocker plus antimuscarinic in men with lower urinary tract symptoms secondary to benign prostatic hyperplasia and overactive bladder: A systematic review and network meta-analysis. Neurourol Urodyn 2024; 43:604-619. [PMID: 38291827 DOI: 10.1002/nau.25399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 12/04/2023] [Accepted: 01/08/2024] [Indexed: 02/01/2024]
Abstract
AIM Antimuscarinics and the β3-adrenoreceptor agonist, mirabegron, are commonly used for treating patients with overactive bladder (OAB) and α1 -adrenoreceptor antagonists (α1 -blockers) are the main pharmacological agents used for treating lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). As these conditions commonly occur together, the aim of this systematic review was to identify publications that compared the use of an α1 -blocker plus mirabegron with an α1 -blocker plus antimuscarinic in men with LUTS secondary to BPH and OAB. A meta-analysis was subsequently conducted to explore the safety and efficacy of these combinations. METHODS Included records had to be from a parallel-group, randomized clinical trial that was ≥8 weeks in duration. Participants were male with LUTS secondary to BPH and OAB. The indirect analyses that were identified compared an α1 -blocker plus OAB agent with an α1 -blocker plus placebo. The PubMed/Medical Literature Analysis and Retrieval System Online, the Excerpta Medica Database, the Cochrane Central Register of Controlled Trials, and the ClinicalTrials.gov registry were searched for relevant records up until March 5, 2020. Safety outcomes included incidences of overall treatment-emergent adverse events (TEAEs) and urinary retention, postvoid residual volume, and maximum urinary flow (Qmax ). Primary efficacy outcomes were micturitions/day, incontinence episodes/day, and urgency episodes/day, and secondary outcomes were Overactive Bladder Symptom Score and International Prostate Symptom Score. A Bayesian network meta-analysis approach was used for the meta-analysis. RESULTS Out of a total of 1039 records identified, 24 were eligible for inclusion in the meta-analysis. There were no statistically significant differences between the α1 -blocker plus mirabegron and α1 -blocker plus antimuscarinic groups in terms of the comparisons identified for all the safety and efficacy analyses conducted. Numerically superior results were frequently observed for the α1 -blocker plus mirabegron group compared with the α1 -blocker plus antimuscarinic group for the safety parameters, including TEAEs, urinary retention, and Qmax . For some of the efficacy parameters, most notably micturitions/day, numerically superior results were noted for the α1 -blocker plus antimuscarinic group. Inconsistency in reporting and study variability were noted in the included records, which hindered data interpretation. CONCLUSION This systematic review and meta-analysis showed that an α1 -blocker plus mirabegron and an α1 -blocker plus antimuscarinic have similar safety and efficacy profiles in male patients with LUTS secondary to BPH and OAB. Patients may, therefore, benefit from the use of either combination within the clinical setting.
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Affiliation(s)
- Sender Herschorn
- Department of Surgery/Urology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Tufan Tarcan
- Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey
- Department of Urology, School of Medicine, Koç University, Istanbul, Turkey
| | - Yuan-Hong Jiang
- Department of Urology, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien, Taiwan
| | - Eric Chung
- Department of Urology, Princess Alexandra Hospital, The University of Queensland, Brisbane, Queensland, Australia
| | | | - Achim Steup
- Astellas Pharma Global Development Inc., Northbrook, Illinois, USA
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Koyanagi YN, Nakatochi M, Namba S, Oze I, Charvat H, Narita A, Kawaguchi T, Ikezaki H, Hishida A, Hara M, Takezaki T, Koyama T, Nakamura Y, Suzuki S, Katsuura-Kamano S, Kuriki K, Nakamura Y, Takeuchi K, Hozawa A, Kinoshita K, Sutoh Y, Tanno K, Shimizu A, Ito H, Kasugai Y, Kawakatsu Y, Taniyama Y, Tajika M, Shimizu Y, Suzuki E, Hosono Y, Imoto I, Tabara Y, Takahashi M, Setoh K, Matsuda K, Nakano S, Goto A, Katagiri R, Yamaji T, Sawada N, Tsugane S, Wakai K, Yamamoto M, Sasaki M, Matsuda F, Okada Y, Iwasaki M, Brennan P, Matsuo K. Genetic architecture of alcohol consumption identified by a genotype-stratified GWAS and impact on esophageal cancer risk in Japanese people. SCIENCE ADVANCES 2024; 10:eade2780. [PMID: 38277453 PMCID: PMC10816704 DOI: 10.1126/sciadv.ade2780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 12/26/2023] [Indexed: 01/28/2024]
Abstract
An East Asian-specific variant on aldehyde dehydrogenase 2 (ALDH2 rs671, G>A) is the major genetic determinant of alcohol consumption. We performed an rs671 genotype-stratified genome-wide association study meta-analysis of alcohol consumption in 175,672 Japanese individuals to explore gene-gene interactions with rs671 behind drinking behavior. The analysis identified three genome-wide significant loci (GCKR, KLB, and ADH1B) in wild-type homozygotes and six (GCKR, ADH1B, ALDH1B1, ALDH1A1, ALDH2, and GOT2) in heterozygotes, with five showing genome-wide significant interaction with rs671. Genetic correlation analyses revealed ancestry-specific genetic architecture in heterozygotes. Of the discovered loci, four (GCKR, ADH1B, ALDH1A1, and ALDH2) were suggested to interact with rs671 in the risk of esophageal cancer, a representative alcohol-related disease. Our results identify the genotype-specific genetic architecture of alcohol consumption and reveal its potential impact on alcohol-related disease risk.
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Affiliation(s)
- Yuriko N. Koyanagi
- Division of Cancer Epidemiology and Prevention, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Masahiro Nakatochi
- Public Health Informatics Unit, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shinichi Namba
- Department of Statistical Genetics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Isao Oze
- Division of Cancer Epidemiology and Prevention, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Hadrien Charvat
- Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan
- Division of International Health Policy Research, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Akira Narita
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Takahisa Kawaguchi
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroaki Ikezaki
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Comprehensive General Internal Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Asahi Hishida
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Megumi Hara
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Toshiro Takezaki
- Department of International Island and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Teruhide Koyama
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yohko Nakamura
- Cancer Prevention Center, Chiba Cancer Center Research Institute, Chiba, Japan
| | - Sadao Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Sakurako Katsuura-Kamano
- Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Kiyonori Kuriki
- Laboratory of Public Health, Division of Nutritional Sciences, School of Food and Nutritional Sciences, University of Shizuoka, Shizuoka, Japan
| | - Yasuyuki Nakamura
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan
| | - Kenji Takeuchi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Division for Regional Community Development, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Kengo Kinoshita
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Yoichi Sutoh
- Division of Biomedical Information Analysis, Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Iwate, Japan
| | - Kozo Tanno
- Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Iwate, Japan
- Division of Clinical Research and Epidemiology, Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Iwate, Japan
| | - Atsushi Shimizu
- Division of Biomedical Information Analysis, Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Iwate, Japan
- Division of Biomedical Information Analysis, Institute for Biomedical Sciences, Iwate Medical University, Iwate, Japan
| | - Hidemi Ito
- Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
- Department of Descriptive Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yumiko Kasugai
- Division of Cancer Epidemiology and Prevention, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
- Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yukino Kawakatsu
- Division of Cancer Epidemiology and Prevention, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Yukari Taniyama
- Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Masahiro Tajika
- Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yasuhiro Shimizu
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Etsuji Suzuki
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yasuyuki Hosono
- Department of Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Issei Imoto
- Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Yasuharu Tabara
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - Meiko Takahashi
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazuya Setoh
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | | - Koichi Matsuda
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
| | - Shiori Nakano
- Division of Epidemiology, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Atsushi Goto
- Division of Epidemiology, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Department of Health Data Science, Graduate School of Data Science, Yokohama City University, Yokohama, Japan
| | - Ryoko Katagiri
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Taiki Yamaji
- Division of Epidemiology, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Norie Sawada
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Shoichiro Tsugane
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masayuki Yamamoto
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Makoto Sasaki
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Iwate, Japan
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Iwate, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yukinori Okada
- Department of Statistical Genetics, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Genome Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Laboratory for Systems Genetics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Laboratory of Statistical Immunology, Immunology Frontier Research Center (WPI-IFReC), Osaka University, Suita, Japan
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Japan
- Center for Infectious Disease Education and Research (CiDER), Osaka University, Suita, Japan
| | - Motoki Iwasaki
- Division of Epidemiology, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Paul Brennan
- Genomic Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
- Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Oyama T, Wada K, Koyama K, Kumagai G, Tanaka S, Asari T, Imai A, Okamoto T, Hatakeyama S, Jung S, Sugimura Y, Ohyama C, Ishibashi Y. Relationship between the cross-sectional area of the lumbar dural sac and lower urinary tract symptoms: A population-based cross-sectional study. PLoS One 2022; 17:e0271479. [PMID: 35951516 PMCID: PMC9371271 DOI: 10.1371/journal.pone.0271479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 07/01/2022] [Indexed: 11/23/2022] Open
Abstract
This study aimed to investigate the relationship between the cross-sectional area of the dural sac (DCSA) and lower urinary tract symptoms (LUTS). This study included 270 Japanese participants from a community health check-up in 2016. Overactive bladder (OAB) was diagnosed during the assessment of LUTS. The smallest DCSA of each participant was defined as the minimum DCSA (mDCSA). The cutoff size of the mDCSA in OAB was evaluated using receiver operating characteristic analysis. Multiple logistic regression analyses were performed to identify the independent risk factors for OAB, and a scoring system was developed for estimating these. The prevalence of OAB was 11.1%. Age and low back pain visual analogue scale (LBP VAS) scores were significantly higher, and the mean mDCSA was significantly lower in participants with OAB than in those without. The cutoff size of mDCSA in OAB was 69 mm2. There were significant correlations between OAB and age, LBP VAS score, and mDCSA<70 mm2. Lumbar spinal stenosis (LSS) should be considered a cause of LUTS when mDCSA is <69 mm2. Assessing the mDCSA with age and LBP VAS score was more valuable in detecting LUTS in LSS than the mDCSA alone.
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Affiliation(s)
- Tetsushi Oyama
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Kanichiro Wada
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
- * E-mail:
| | - Kazushige Koyama
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Gentaro Kumagai
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Sunao Tanaka
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Toru Asari
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Atsushi Imai
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Teppei Okamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Songee Jung
- Department of Digital Nutrition and Health Sciences, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Yoshikuni Sugimura
- Department of Microbial Flora and Health Science, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Yasuyuki Ishibashi
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
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Dai R, Chen Y, Yang K, Wu T, Deng C. Association Between Trp64Arg Polymorphism of Beta-3 Adrenergic Receptor Gene and Susceptibility to Overactive Bladder: A Meta-Analysis. Front Genet 2022; 13:930084. [PMID: 35903356 PMCID: PMC9315387 DOI: 10.3389/fgene.2022.930084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 06/17/2022] [Indexed: 11/30/2022] Open
Abstract
Objective: Some studies have been carried out to investigate the association between Trp64Arg polymorphism in beta-3 adrenergic receptor gene (ADRB3) and susceptibility to overactive bladder (OAB), but the results remain inconsistent. We carried out a meta-analysis to acquire a more accurate estimation. Methods: All eligible studies were searched in PubMed, Web of Science, Embase, and Cochrane Library. Pooled odds ratios, with 95% confidence intervals, were assessed for the association using fixed and random effects models. Results: The overall results of this meta-analysis demonstrated that there might be an association between Trp64Arg polymorphism and susceptibility to OAB in allele model, dominant model, and heterozygote comparison with a relative risk of 2.00 (95% CI 1.36–2.93), 2.13 (95% CI 1.20–3.76), and 2.07 (95% CI: 1.13–3.79), respectively. However, in the recessive model and homozygote comparison, no significant association between ESR1 Trp64Arg polymorphism and susceptibility to OAB was observed, with a relative risk of 2.47 (95% CI 0.63–9.73) and 3.12 (95% CI: 0.79–12.35), respectively. Based on trail sequential analysis, the results turned out to be true positive in the allele model, false positive in the dominant model and heterozygote comparison, and negative in the recessive model and homozygote comparison, respectively. Conclusion: Our analysis indicated that Trp64Arg polymorphisms in ADRB3 might increase the risk of OAB twice in the allele model, but further well-designed studies with large sample sizes are required to confirm the present findings in other modes and comparisons.
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Affiliation(s)
- Rong Dai
- Chengdu Center for Disease Control and Prevention, Chengdu, China
| | - Yue Chen
- Chengdu Center for Disease Control and Prevention, Chengdu, China
| | - Kai Yang
- Chengdu Center for Disease Control and Prevention, Chengdu, China
| | - Tao Wu
- Chenghua Center for Disease Control and Prevention, Chengdu, China
| | - Changkai Deng
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- *Correspondence: Changkai Deng,
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Prevalence of and Associated Factors for Overactive Bladder Subtypes in Middle-Aged Women: A Cross-Sectional Study. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58030383. [PMID: 35334559 PMCID: PMC8950349 DOI: 10.3390/medicina58030383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/17/2022] [Accepted: 03/02/2022] [Indexed: 11/30/2022]
Abstract
Background and Objectives: The living environment can manifest physiological responses in humans, with cohabiting couples often having similar health statuses. The aim of this study was to (1) examine the prevalence of the overactive bladder (OAB) with or without incontinence and (2) identify associated factors for OAB with and without incontinence (including environmental factors, such as living with a partner who has OAB) in middle-aged women. Materials and Methods: In this cross-sectional study, the International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OBA) was administered to 970 couples. Data were analyzed using descriptive statistics, chi-square analyses, and multivariate logistic regression. Results: Responses to the ICIQ-OBA among middle-aged women generated a higher prevalence of OAB with incontinence (OABwet; 41%) than OAB without incontinence (OABdry; 26%; p < 0.001). The factors associated with OABwet were as follows: being age ≥ 55 years (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.02−1.95), having a body mass index (BMI) ≥ 27 kg/m2 (OR, 1.50; 95% CI, 1.03−2.17), having vaginitis (OR, 1.89; 95% CI, 1.28−2.80), and having partners with OABwet (OR, 2.35; 95% CI, 1.74−3.19). Having partners with OABdry (OR, 1.81; 95% CI, 1.34−2.44) was an associated factor for OABdry. Conclusions: This study identified the associated factors for OAB subtypes (OABwet and OABdry) in middle-aged women. These findings can support treatment and preventive strategies for health providers who care for patients with OAB. As part of the treatment and preventative strategies, the risk that partners may introduce to the development of OAB in women should also be considered.
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Funada S, Luo Y, Yoshioka T, Setoh K, Tabara Y, Negoro H, Akamatsu S, Yoshimura K, Matsuda F, Furukawa TA, Efthimiou O, Ogawa O. Protocol for development and validation of a prediction model for 5-year risk of incident overactive bladder in the general population: the Nagahama study. BMC Urol 2021; 21:78. [PMID: 33985490 PMCID: PMC8120704 DOI: 10.1186/s12894-021-00848-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/09/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND An accurate prediction model could identify high-risk subjects of incident Overactive bladder (OAB) among the general population and enable early prevention which may save on the related medical costs. However, no efficient model has been developed for predicting incident OAB. In this study, we will develop a model for predicting the onset of OAB at 5-year in the general population setting. METHODS Data will be obtained from the Nagahama Cohort Project, a longitudinal, general population cohort study. The baseline characteristics were measured between Nov 28, 2008 and Nov 28, 2010, and follow-up was performed every 5 years. From the total of 9,764 participants (male: 3,208, female: 6,556) at baseline, we will exclude participants who could not attend the follow-up assessment and those who were defined as having OAB at baseline. The outcome will be incident OAB defined using the Overactive Bladder Symptom Score (OABSS) at follow-up assessment. Baseline questionnaires (demographic, health behavior, comorbidities and OABSS) and blood test data will be included as predictors. We will develop a logistic regression model utilizing shrinkage methods (LASSO penalization method). Model performance will be evaluated by discrimination and calibration. Net benefit will be evaluated by decision curve analysis. We will perform an internal validation and a temporal validation of the model. We will develop a web-based application to visualize the prediction model and facilitate its use in clinical practice. DISCUSSION This will be the first study to develop a model to predict the incidence of OAB.
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Affiliation(s)
- Satoshi Funada
- Department of Urology, Faculty of Medicine, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. .,Department of Health Promotion and Human Behavior, Kyoto University School of Public Health, Kyoto, Japan.
| | - Yan Luo
- Department of Health Promotion and Human Behavior, Kyoto University School of Public Health, Kyoto, Japan
| | - Takashi Yoshioka
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima City, Fukushima, Japan.,Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine and School of Public Health, Kyoto, Japan
| | - Kazuya Setoh
- Center for Genomic Medicine, Faculty of Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasuharu Tabara
- Center for Genomic Medicine, Faculty of Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | | - Shusuke Akamatsu
- Department of Urology, Faculty of Medicine, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Koji Yoshimura
- Department of Urology, Shizuoka General Hospital, Shizuoka, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Faculty of Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University School of Public Health, Kyoto, Japan
| | - Orestis Efthimiou
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Department of Psychiatry, University of Oxford, Oxford, UK
| | - Osamu Ogawa
- Department of Urology, Faculty of Medicine, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
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8
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The Prevalence of Overactive Bladder Symptoms in Women in Algeria, Egypt, Jordan and Lebanon: A Cross-Sectional Population-Based Survey. Adv Ther 2021; 38:1155-1167. [PMID: 33354738 PMCID: PMC7889545 DOI: 10.1007/s12325-020-01588-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/28/2020] [Indexed: 01/10/2023]
Abstract
Aims Estimate the prevalence of symptoms suggestive of overactive bladder (OAB) in women living in the Middle East to describe their demographic characteristics and explore treatment-seeking behavior. Methods Cross-sectional, population-based survey of women aged ≥ 40 years resident in Algeria, Jordan, Lebanon or Egypt. Respondents were recruited using computer-assisted telephone interview over approximately 4 months. Eligible respondents were asked to complete the OAB-V8, a validated questionnaire that explores the extent of bother from the key symptoms of OAB without clinical investigations. In addition, information regarding demographics, comorbidities and treatment behavior was collected, and respondents were stratified by age. Results A total of 2297 eligible women agreed to participate. Mean age was 54 ± 10 years; over half (59.3%) were aged 40–55 years. Overall, 53.8% of eligible women had symptoms suggestive of OAB (Jordan 58.5%; Egypt 57.5%; Algeria 49.9%; Lebanon 49.0%), with over 90% also reporting symptoms of urinary incontinence. Only 13.0% of women with symptoms suggestive of OAB were currently receiving treatment, while most (74.3%) had never been treated; these data were consistent across country and age categories. Among the untreated subgroup, almost half (48.7%) reported they were ‘not bothered by symptoms,’ while 8.4% considered OAB to be ‘part of normal aging’ and 4.7% did not know it was treatable. Conclusion A high prevalence of symptoms suggestive of OAB was observed, and the majority had symptoms of urinary incontinence. Despite the high prevalence, most women had never received treatment. Considering the potential significant impact of OAB symptoms on health, quality of life and productivity, these findings highlight an unmet medical need in the population studied. Strategies to improve treatment-seeking behavior (e.g., through education and tackling the stigma associated with OAB symptoms) may improve the diagnosis, management and health outcomes of women with OAB in the Middle East. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-020-01588-4.
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9
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Post WM, Ruiz-Zapata AM, Grens H, de Vries RBM, Poelmans G, Coenen MJH, Janssen DAW, Heesakkers JPFA, Oosterwijk E, Kluivers KB. Genetic variants and expression changes in urgency urinary incontinence: A systematic review. Neurourol Urodyn 2020; 39:2089-2110. [PMID: 32949220 PMCID: PMC7692907 DOI: 10.1002/nau.24512] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/17/2020] [Accepted: 09/04/2020] [Indexed: 12/12/2022]
Abstract
Aim To perform a systematic review summarizing the knowledge of genetic variants, gene, and protein expression changes in humans and animals associated with urgency urinary incontinence (UUI) and to provide an overview of the known molecular mechanisms related to UUI. Methods A systematic search was performed on March 2, 2020, in PubMed, Embase, Web of Science, and the Cochrane library. Retrieved studies were screened for eligibility. The risk of bias was assessed using the ROBINS‐I (human) and SYRCLE (animal) tool. Data were presented in a structured manner and in the case of greater than five studies on a homogeneous outcome, a meta‐analysis was performed. Results Altogether, a total of 10,785 records were screened of which 37 studies met the inclusion criteria. Notably, 24/37 studies scored medium‐high to high on risk of bias, affecting the value of the included studies. The analysis of 70 unique genes and proteins and three genome‐wide association studies showed that specific signal transduction pathways and inflammation are associated with UUI. A meta‐analysis on the predictive value of urinary nerve growth factor (NGF) levels showed that increased urinary NGF levels correlate with UUI. Conclusion The collective evidence showed the involvement of two molecular mechanisms (signal transduction and inflammation) and NGF in UUI, enhancing our understanding of the pathophysiology of UUI. Unfortunately, the risk of bias was medium‐high to high for most studies and the value of many observations remains unclear. Future studies should focus on elucidating how deficits in the two identified molecular mechanisms contribute to UUI and should avoid bias.
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Affiliation(s)
- Wilke M Post
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Alejandra M Ruiz-Zapata
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hilde Grens
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rob B M de Vries
- Department for Health Evidence, SYRCLE, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Geert Poelmans
- Department of Human Genetics, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marieke J H Coenen
- Department of Human Genetics, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dick A W Janssen
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Egbert Oosterwijk
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Kirsten B Kluivers
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
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10
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Impact of Cold Indoor Temperatures on Overactive Bladder: A Nationwide Epidemiological Study in Japan. Urology 2020; 145:60-65. [PMID: 32835744 DOI: 10.1016/j.urology.2020.08.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/07/2020] [Accepted: 08/10/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the relationship between overactive bladder (OAB) and indoor temperatures in the living room and bedroom. METHODS Questionnaire data and indoor temperature measurements were obtained from a baseline survey collected during the winter months from November 2014 to March 2019. We performed multiple logistic regression to assess the relationships between OAB and indoor temperatures in the living room and bedroom. RESULTS The prevalence of overactive bladder was 16.4% among 4782 participants living in 2453 dwellings. The odds of having OAB were higher for participants whose average living room temperature at bedtime was lower than 12°C than for those whose average bedtime living room temperature was at least 18°C (adjusted odds ratio = 1.44, 95% confidence interval: 1.03-2.00). No association was observed between bedroom temperature and OAB. CONCLUSION These results suggest that thermal comfort in the living room-but not in the bedroom-may improve OAB symptoms. Additionally, using sufficient bedding may prevent cold bedrooms from having a negative impact in terms of OAB. Future studies should focus on housing interventions and education regarding lifestyle modification in patients with OAB.
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11
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Funada S, Watanabe N, Goto T, Negoro H, Akamatsu S, Ueno K, Uozumi R, Ichioka K, Segawa T, Akechi T, Furukawa TA, Ogawa O. Cognitive behavioral therapy for overactive bladder in women: study protocol for a randomized controlled trial. BMC Urol 2020; 20:129. [PMID: 32819331 PMCID: PMC7439638 DOI: 10.1186/s12894-020-00697-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 08/14/2020] [Indexed: 11/17/2022] Open
Abstract
Background Overactive bladder (OAB) symptoms affect daily life by decreasing health-related quality of life (HRQol). However, there remain no very effective treatment for OAB. Pharmacotherapy is one of the best treatments, but it is not always efficient and may incur adverse events. Although behavioral therapy is another effective treatment, there are very few structured treatment manuals on how to prescribe behavioral therapy to treat OAB for whom. Cognitive behavioral therapy (CBT) is a psychotherapy consisting of structured sessions to solve problems with the collaborative empiricism between therapists and patients. OAB symptoms are supposed to worsen with cognitive distortion, and CBT is expected to be effective in treating OAB by modifying such cognitive processes. In this trial, we will evaluate the efficacy of CBT for OAB. Methods A randomized, controlled, open-label, multicenter parallel-group superiority trial will be conducted. Participants with moderate to severe OAB symptoms with or without pharmacotherapy will be recruited and will be randomly allocated 1:1 to two different groups by minimization (age, baseline OAB severity, treatment status, types of intervention, and treating institutions). The intervention group will be prescribed an individual CBT program covering six techniques in 4 sessions (30 min each), with or without pharmacotherapy. The primary outcome is the change scores in an OAB-questionnaire (OAB-q) from baseline to the end of the trial (week 13). Secondary outcomes will include other patient reported outcome measures and the frequency volume chart. All analyses will be conducted on an intention-to-treat principle. Discussion This trial will determine the efficacy of CBT to treat OAB using a rigorous methodology. The effectiveness of CBT with a structured manual may not only lead to a new treatment option for patients suffering from OAB symptoms, but may also reduce the social burden by OAB. Trial registration UMIN-CTR Clinical Trial, CTR-UMIN000038513. Registered on November 7, 2019.
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Affiliation(s)
- Satoshi Funada
- Department of Urology, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. .,Department of Health Promotion and Human Behavior, Kyoto University School of Public Health, Kyoto, Japan. .,Department of Psychiatry, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
| | - Norio Watanabe
- Department of Health Promotion and Human Behavior, Kyoto University School of Public Health, Kyoto, Japan
| | - Takayuki Goto
- Department of Urology, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Hiromitsu Negoro
- Department of Urology, University of Tsukuba Hospital, Tsukuba, Japan
| | - Shusuke Akamatsu
- Department of Urology, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Kentaro Ueno
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryuji Uozumi
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | | | | - Tatsuo Akechi
- Department of Psychiatry, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Toshiaki A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University School of Public Health, Kyoto, Japan
| | - Osamu Ogawa
- Department of Urology, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
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12
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Takahashi S, Kato D, Tabuchi H, Uno S. Safety and effectiveness of mirabegron in male patients with overactive bladder with or without benign prostatic hyperplasia: A Japanese post-marketing study. Low Urin Tract Symptoms 2020; 13:79-87. [PMID: 32761776 PMCID: PMC7818393 DOI: 10.1111/luts.12335] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/28/2020] [Accepted: 06/09/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aim of this post hoc analysis from the Japanese mirabegron surveillance program was to investigate the safety and effectiveness of mirabegron in male patients with overactive bladder (OAB) symptoms with/without concomitant benign prostatic hyperplasia (BPH). METHODS This 12-week study included patients who were starting mirabegron treatment for the OAB symptoms of urinary urgency, daytime frequency, and urgency urinary incontinence. Patients were stratified according to BPH diagnosis, and patients with BPH were stratified into those who did/did not receive BPH-specific treatment. Assessments included adverse drug reactions (ADRs), residual urine volume evaluations, and total Overactive Bladder Symptom Score (OABSS) and International Prostate Symptom Score-Quality of Life (IPSS-QoL) measurements. RESULTS Of 4540 male patients, 3176 (70.0%) had been diagnosed with BPH. Mean age was slightly higher in patients with BPH (74.7 ± 8.41 years) versus patients without BPH (71.0 ± 12.13 years). Overall, 66/1364 (4.84%), 170/2588 (6.57%), and 35/569 (6.15%) patients without BPH, with BPH + treatment, and with BPH + no treatment, respectively, experienced ≥1 ADR. No patients without BPH and 21/3176 (0.66%) patients with BPH experienced a urinary retention ADR. No significant changes from baseline to week 12 in residual volume were noted. Mirabegron was judged to be an effective treatment for 990/1296 (76.4%) patients without BPH, 1935/2491 (77.7%) patients with BPH + treatment, and 421/538 (78.3%) patients with BPH + no treatment. Significant decreases in total OABSS and IPSS-QoL were observed for all groups. CONCLUSIONS Mirabegron was a well-tolerated and effective treatment for patients with OAB symptoms with or without BPH in this post-marketing study.
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Affiliation(s)
| | - Daisuke Kato
- Medical Science, Medical Affairs, Astellas Pharma Inc., Tokyo, Japan
| | - Hiromi Tabuchi
- Medical Science, Medical Affairs, Astellas Pharma Inc., Tokyo, Japan
| | - Satoshi Uno
- Japan-Asia Data Science, Development, Astellas Pharma Inc., Tokyo, Japan
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13
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Funada S, Watanabe N, Goto T, Negoro H, Akamatsu S, Uozumi R, Kishimoto S, Ichioka K, Segawa T, Furukawa TA, Ogawa O. Clinical feasibility and acceptability of adding cognitive behavioral therapy to pharmacotherapy for drug-resistant overactive bladder in women: A single-arm pilot study. Low Urin Tract Symptoms 2020; 13:69-78. [PMID: 32618414 DOI: 10.1111/luts.12333] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 05/08/2020] [Accepted: 05/19/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Drug-resistant overactive bladder (OAB) represents an unmet medical need in that treatment options are limited. We developed a treatment model based on cognitive behavioral therapy and evaluated its feasibility and acceptability for drug-resistant OAB in women. METHODS This was an open-label, single-arm, multicenter pilot study. We defined drug-resistant OAB as OAB with moderate to severe symptoms despite pharmacotherapy for more than 12 weeks. A face-to-face intervention was prescribed as six sessions (30 minutes each) over 6 to 12 weeks according to a treatment manual. The effects were assessed by self-reported questionnaires and frequency voiding charts (FVC) at baseline, during intervention, immediately after intervention, and at follow-up. RESULTS Ten patients participated in this study. Median age was 72 years, median OAB Symptom Score was nine points, and median duration of prior treatment for OAB was 5.5 years at baseline. Two participants dropped out of the study. Among the remaining patients, the scores of the OAB Questionnaire subscales improved (effect size: 0.75-1.73), and the mean urinary frequency in the FVC also improved from baseline (9.0 times, SD: 2.1) to follow-up (6.2 times, SD: 1.2). All participants were satisfied with the intervention. There were no adverse events during this study. CONCLUSIONS The new treatment based on cognitive behavioral therapy was well tolerated and feasible in women with drug-resistant OAB. Further randomized research is needed to rigorously evaluate the efficacy of the treatment.
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Affiliation(s)
- Satoshi Funada
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Health Promotion and Human Behavior, Kyoto University School of Public Health, Kyoto, Japan
| | - Norio Watanabe
- Department of Health Promotion and Human Behavior, Kyoto University School of Public Health, Kyoto, Japan
| | - Takayuki Goto
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiromitsu Negoro
- Department of Urology, University of Tsukuba Hospital, Ibaraki, Japan
| | - Shusuke Akamatsu
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryuji Uozumi
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Sanae Kishimoto
- Department of Health Promotion and Human Behavior, Kyoto University School of Public Health, Kyoto, Japan
| | | | | | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University School of Public Health, Kyoto, Japan
| | - Osamu Ogawa
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
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14
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Shiota T, Torimoto K, Okuda M, Iwata R, Kumamoto H, Miyake M, Hirayama A, Tanaka N, Fujimoto K. Cognitive burden and polypharmacy in elderly Japanese patients treated with anticholinergics for an overactive bladder. Low Urin Tract Symptoms 2019; 12:54-61. [PMID: 31460706 DOI: 10.1111/luts.12285] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 07/09/2019] [Accepted: 07/26/2019] [Indexed: 12/14/2022]
Abstract
This study aimed to investigate the cognitive burden and polypharmacy in elderly patients treated with anticholinergics for an overactive bladder. We conducted a retrospective study of patients with an overactive bladder receiving treatment at two hospitals in Japan (Nara Medical University Hospital and Saiseikai Nara Hospital). Prescription data were collected from the medical records of the patients registered between January 2013 and April 2014. The Anticholinergic Cognitive Burden Scale was used to estimate the severity of the anticholinergic effects on the cognition of each patient. We collected the prescription data of 584 and 246 patients from the Nara Medical University Hospital and Saiseikai Nara Hospital, respectively. The mean daily total Anticholinergic Cognitive Burden score ranged between 3 and 4 (3.59 ± 1.16 at Nara Medical University Hospital vs 3.32 ± 0.78 at Saiseikai Nara Hospital, P < 0.01). At both hospitals, the mean number of prescriptions was >5 in patients ≥75 years (5.95 ± 4.43 and 5.64 ± 3.90 at Nara Medical University Hospital and Saiseikai Nara Hospitals, respectively). Our findings suggest that 10%-20% of elderly patients (≥65 years) receiving treatment with anticholinergics for an overactive bladder are in a state of polypharmacy. The total anticholinergic cognitive burden of each patient mainly depends on the anticholinergics being used for treating the overactive bladder. Especially for elderly patients with a high risk of adverse effects, including cognitive impairment, careful attention needs to be paid during selection of drugs for treating patients with an overactive bladder.
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Affiliation(s)
- Takako Shiota
- Department of Urology, Nishi Nara Central Hospital, Nara, Japan
| | | | - Masahiro Okuda
- Department of Pharmacy, Saiseikai Nara Hospital, Nara, Japan
| | - Ryo Iwata
- Department of General Affairs, Saiseikai Nara Hospital, Nara, Japan
| | | | - Makito Miyake
- Department of Urology, Nara Medical University, Nara, Japan
| | - Akihide Hirayama
- Department of Urology, Kindai University Nara Hospital, Nara, Japan
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