PMID- 37500569
OWN - NLM
STAT- MEDLINE
DCOM- 20231220
LR  - 20240105
IS  - 1464-410X (Electronic)
IS  - 1464-4096 (Linking)
VI  - 133
IP  - 1
DP  - 2024 Jan
TI  - Detrusor relaxing agents for neurogenic detrusor overactivity: a systematic 
      review, meta-analysis and network meta-analysis.
PG  - 25-33
LID - 10.1111/bju.16142 [doi]
AB  - OBJECTIVE: To evaluate the evidence regarding the therapeutic benefits and safety 
      of oral detrusor relaxing agents (DRAs) in treating neurogenic detrusor 
      overactivity (NDO). METHODS: A comprehensive search was performed on 1 September 
      2022. Two authors independently reviewed the articles to extract data using a 
      pre-designed form. The meta-analysis was performed following the Preferred 
      Reporting Items for Systematic Reviews and Meta-Analyses statement. A 
      common-effect or random-effects model was used based on the heterogeneity among 
      studies. Bayesian network meta-analysis (NMA) was further performed to make 
      indirect comparisons of antimuscarinics and mirabegron. RESULTS: A total of 23 
      randomised controlled trials (RCTs) comprising 1697 patients were included in our 
      analysis. Compared to placebo, the clinical benefits of oral DRAs, along with 
      more adverse events (AEs), were demonstrated in the treatment of NDO. In the 
      subgroup analysis, antimuscarinics significantly improved both urodynamic and 
      bladder diary outcomes (including urinary incontinence episodes, urinary 
      frequency, and residual volume), with a higher rate of AEs, such as xerostomia. 
      Mirabegron improved some of the parameters and had fewer bothersome side-effects 
      in patients with NDO. The NMA showed that none of the antimuscarinics or 
      mirabegron was superior or inferior to the other. CONCLUSIONS: Detrusor relaxing 
      agents are associated with improved outcomes in patients with NDO and our 
      analysis has added new evidence regarding antimuscarinics. Evidence concerning 
      mirabegron as first-line therapy for NDO is still limited. Well-designed RCTs are 
      still required in this specific population.
CI  - (c) 2023 BJU International.
FAU - Zhou, Zhonghan
AU  - Zhou Z
AUID- ORCID: 0000-0002-7927-1393
AD  - Shandong University, Jinan, Shandong, China.
AD  - Department of Urology, China Rehabilitation Research Center, Beijing, China.
AD  - China Rehabilitation Science Institute, Beijing, China.
AD  - University of Health and Rehabilitation Sciences, Qingdao, Shandong, China.
AD  - School of Rehabilitation, Capital Medical University, Beijing, China.
AD  - Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, China.
FAU - Wang, Xuesheng
AU  - Wang X
AUID- ORCID: 0000-0002-5612-6804
AD  - Department of Urology, China Rehabilitation Research Center, Beijing, China.
AD  - China Rehabilitation Science Institute, Beijing, China.
AD  - University of Health and Rehabilitation Sciences, Qingdao, Shandong, China.
AD  - School of Rehabilitation, Capital Medical University, Beijing, China.
AD  - Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, China.
FAU - Li, Xunhua
AU  - Li X
AD  - Department of Urology, China Rehabilitation Research Center, Beijing, China.
AD  - China Rehabilitation Science Institute, Beijing, China.
AD  - University of Health and Rehabilitation Sciences, Qingdao, Shandong, China.
AD  - School of Rehabilitation, Capital Medical University, Beijing, China.
AD  - Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, China.
FAU - Liao, Limin
AU  - Liao L
AUID- ORCID: 0000-0002-7092-6576
AD  - Department of Urology, China Rehabilitation Research Center, Beijing, China.
AD  - China Rehabilitation Science Institute, Beijing, China.
AD  - University of Health and Rehabilitation Sciences, Qingdao, Shandong, China.
AD  - School of Rehabilitation, Capital Medical University, Beijing, China.
AD  - Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, China.
LA  - eng
GR  - 82170792/National Natural Science Foundation of China/
GR  - 7222234/Natural Science Foundation of Beijing Municipality/
GR  - 2021zx-10/the Research Projects of China Rehabilitation Research Centre/
GR  - 2023CZ-1/the central public welfare research institutes/
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20230808
PL  - England
TA  - BJU Int
JT  - BJU international
JID - 100886721
RN  - MVR3JL3B2V (mirabegron)
RN  - 0 (Muscarinic Antagonists)
RN  - EC 3.4.24.69 (Botulinum Toxins, Type A)
SB  - IM
MH  - Humans
MH  - *Urinary Bladder, Neurogenic/drug therapy
MH  - Muscarinic Antagonists/therapeutic use
MH  - Network Meta-Analysis
MH  - *Botulinum Toxins, Type A/adverse effects
MH  - Treatment Outcome
MH  - *Urinary Bladder, Overactive/drug therapy
MH  - Urodynamics
MH  - Randomized Controlled Trials as Topic
OTO - NOTNLM
OT  - antimuscarinics
OT  - detrusor relaxing agent
OT  - meta-analysis
OT  - mirabegron
OT  - neurogenic detrusor overactivity
EDAT- 2023/07/28 01:08
MHDA- 2023/12/20 06:42
CRDT- 2023/07/27 22:14
PHST- 2023/12/20 06:42 [medline]
PHST- 2023/07/28 01:08 [pubmed]
PHST- 2023/07/27 22:14 [entrez]
AID - 10.1111/bju.16142 [doi]
PST - ppublish
SO  - BJU Int. 2024 Jan;133(1):25-33. doi: 10.1111/bju.16142. Epub 2023 Aug 8.