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과민성 방광 환자의 치료 지속성 : 한국, 호주 국립 코호트 데이터베이스 연구 |
| 성균관대학교 의과대학 삼성서울병원¹;계명대학교 의과대학 동산의료원, 대구²; IQVIA 말레이시아³;아스텔라스제약 싱가포르⁴;성균관대학교 삼성융합의과학원 임상연구설계평가학과5 |
| 이규성¹, 박혜정¹, 강단비¹, 변혜진², 푸치영³, 압둘하디 패리드⁴, 김소영⁴, 조주희5 |
Introduction
This study was conducted to evaluate the real-world persistence with antimuscarinics and the β3-adrenoreceptor agonist, mirabegron, among adults in Korea and Australia.
Methods
This was a non-interventional, retrospective study of two national databases, Health Insurance Review and Assessment (HIRA) from Korea and NostraData from Australia (ClinicalTrials.gov: NCT03602508). Adults (≥18 yr) who newly received a target overactive bladder (OAB) medication (mirabegron/antimuscarinic) from 01 Jul 15–29 Feb 16 were included and followed for 12 mo to assess treatment persistence (time to discontinuation/switching). Patients were excluded if they were prescribed their index medication during the previous 6 mo. Persistence was assessed using the Kaplan-Meier method and subanalyses were conducted according to age group (<65, ≥65 yr), sex, and OAB medication experience (naïve, experienced).
Results
In total, 52722 and 12281 patients with OAB were included from HIRA and NostraData, respectively. Korean patients were more likely to be younger (mean±standard deviation: 60.9±16.1 vs 66.2±16.3 yr) and male (21860 [41.5%] vs 3718 [30.3%]) compared with Australian patients. Median persistence with mirabegron vs antimuscarinics was 51 vs 25 days (individual agents: 8–31) from the HIRA database and 60 vs 100 days (37–100) from the NostraData database (Table). The reverse outcome in Australia was mainly due to the oxybutynin results. Patients who were aged ≥65 yr, male (HIRA database only), and had prior OAB medication experience typically exhibited longer treatment persistence than younger, female, and treatment-naïve patients.
Conclusions
In this large, real-world analysis, median persistence was longer with mirabegron than with antimuscarinics in Korea. The reverse finding was observed in Australia, mainly due to the results for oxybutynin. In Australia, oxybutynin is the only government subsidized OAB medication; as a result, the overall findings might be biased. |
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keywords : Mirabegron, antimuscarinics, persistence |
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