Author/Editor     Hajdinjak, Tine; Leskovar, Jurij
Title     Darifenacin v praksi
Translated title     Darifenacin in a real-world practice
Type     članek
Vol. and No.     Letnik 82, št. 5
Publication year     2013
Volume     str. 288-297
ISSN     1581-0224 - Zdravniški vestnik
Language     slv
Abstract     Izhodišča: Zdravljenje simptomov čezmerno aktivnega sečnega mehurja (PASM) bolniki marsikdaj prekinejo, poročajo o neželenih učinkih (NU) in menjajo zdravila. Kateri dejavniki vplivajo na to, smo za novejši M3 selektivni antiholinergik darifenacin preučevali v razmerah vsakodnevne klinične prakse. Metode: Opazovalna prospektivna 24-tedenska multicentrična raziskava IV. faze. Bolnikom s PASM je bil predpisan darifenacin. Ocenjevali so se NU in sodelovanje pri zdravljenju. Uspeh zdravljenja se je ocenjeval kot sprememba na 6-stopenjski lestvici ocene stanja. Rezultati: 710 bolnikov: 218 moških in 492 žensk, povprečna starost 61 let. 19,2 % bolnikov je odstopilo ali ni opazilo izboljšanja, 48,2 % je poročalo o izboljšanju za 12 stopnji in 32,7 % o izboljšanju za 3 stopnje ali več. Večje izboljšanje je bilo ugotovljeno pri tistih, ki so na začetku poročali o hujših težavah in pri mlajših. Spol, predhodno zdravljenje z antiholinergikom ali pojav NU niso bili povezani z uspehom zdravljenja. Darifenacin je prejemalo 6 mesecev 581 (81,8 %) bolnikov, 542 (76,3 %) pa jih je nadaljevalo z zdravljenjem po koncu raziskave. Napovedni dejavniki za prekinitev zdravljenja so bili: pojav NU, starost (mlajši so pogosteje prenehali zdravljenje) in trajanje simptomov (tisti s krajšim trajanjem težav so pogosteje prekinili zdravljenje). Stopnja težav, jemanje antiholinergika pred tem ali spol niso bili povezani s prenehanjem jemanja zdravila. O NU je poročalo 192 (27 %) bolnikov, ženske pogosteje kot moški. Trajanje simptomov ali stopnja težav niso bili povezani z NU. Zaključki: Darifenacin je enako učinkovit pri obeh spolih in je lahko antiholinergik prve izbire in enako koristi po neuspehu zdravljenja z drugim antiholinergikom.Introduction: Patients often stop treatment and report adverse events when treated with drugs for overactive bladder (OAB). Which predictors influence compliance and treatment success was studied for M3 selective anticholinergic darifenacin in a real-world situation. Methods: Prospective observational multicentre 24-week phase IV trial. Patients with OAB were prescribed darifenacin. Adverse effects and compliance with treatment were evaluated. Treatment success was evaluated as change in the bother score on the 6-point scale for condition assessment. Results: 710 patients: 218 males, 492 females, mean age 61 years. 19.2 % were either lost or reported no improvement, 48.2 % reported improvement by 1 or 2 grades and 32.7 % improved by 3 or more grades. Better treatment success was found among those with more problems (higher bother) and younger. Gender, previous exposure to anticholinergics or presence of adverse effects were not related to treatment success. 581 (81.8 %) of included patients were on treatment for the duration of the study and 542 (76.3 %) continued after 6 months. The most significant predictor for discontinuation of treatment was the presence of adverse events (reactions), others were age (younger tend to stop treatment) and duration of problems (those with shorter duration tend to stop). Grade of problems, previous anticholinergic or gender were not related to discontinuation of treatment. Adverse events were reported by 192 patients (27 %). Females reported adverse events more often than males. Duration or grade of symptoms and age were not related to adverse events. Conclusions: Darifenacin is equally effective in both genders. It is the first-choice anticholinergic and is also useful in cases where other anticholinergics fail.
Keywords     sečni mehur, čezmerno aktivni
antiholinergična zdravila
neželeni učinki
kakovost življenja
sodelovanje bolnika