과민성방광은 연령이 증가함에 따라 유병률이 증가하고 있으나, 질병에 대한 인식 도나 치료율이 아직 높지 않다. 또한, 치료를 시작한 환자도 치료를 지속하는 비율이 낮다고 알려져 있다. 이러한 치료 지속율을 낮추는 이유는 기존 약제인 항콜린제의 부작용으로 인한 중단이 상당한 것으로 알려져 있다. 최근 승인받은 새로운 계열의 베타3 아드레날린 수용체 작용제인 미라베그론은 항콜린제와는 다른 기전으로 배뇨근 의 이완과 방광 저장 능력을 향상시킴으로서, 과민성방광증상에 효과가 있으며 기존 항콜린성 부작용은 거의 없는 것으로 알려져 있다. 그러나, 베타 수용체가 방광이외 심혈관계에도 분포함에 따른 혈압상승과 같은 심혈관계 안전성 및 장기간 안전성에 대한 우려가 있다. 그러므로, 제품허가사항에 따르면, 조절되지 않는 중증의 고혈압 환자의 경우, 금기로 되어 있다.
본 연구에서는 미라베그론의 과민성방광증상과 삶의 질 개선, 안전성(심혈관계 안전 성 포함)에 대해 알아보기 위해 체계적 문헌고찰과 메타분석을 실시하였으며, 아래와 같은 결론을 도출하였다.
첫째, 미라베그론은 위약에 비해 배뇨횟수, 요절박 등의 객관적인 과민성방광증상 뿐 아니라, OAB-q, PPBC 등으로 확인한 주관적 방광 증상 개선에 있어 유의한 개선 이 있었다. 또한, 안전성에 있어서는 위약과 비교하여 유의한 차이가 없었다.
둘째, 미라베그론은 기존 항콜린제에 비해 대부분 객관적/주관적 과민성방광증상에 있어서 유의한 차이가 없었으며, 대부분의 부작용이 기존 항콜린제 대비하여 적은 경 향성을 보였으나 구갈을 제외한 부작용에 있어서는 유의한 차이가 없었다.
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연번 검색어 검색건수
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#2 b3 adrenergic[Title] 12
#3 #1 OR #2 190
#4 overactive bladder[Title] 2636
#5 #3 AND #4 113
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#3 overactive:ti AND bladder:ti 4190
#4 #1 OR #2 464
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#1 mirabegron 5
Limits Activated: Clinical Trial, Comparative Study, Controlled Clinical Trial, Evaluation Studies, Observational Study, Original Article, Randomized Controlled Trial, Humans, Cited in KoMCI, Cited in Synapse/CrossRef
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#1 mirabegron (검색필드 : 전체) 5
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