Comparative assessment of efficacy and safety of different treatment for de novo overactive bladder children: A systematic review and network meta-analysis  

作　　者：Shi Qiu Siwei Bi Tianhai Lin Zhuheng Wu Qi’an Jiang Jiwen Geng Liangren Liu Yige Bao Xiang Tu Mingjing He Lu Yang Qiang Wei 

机构地区：[1]Department of Urology,Institute of Urology,West China Hospital of Sichuan University,Chengdu,China

出　　处：《Asian Journal of Urology》2019年第4期330-338,共9页亚洲泌尿外科杂志（英文）

基　　金：This study was supported by the Prostate Cancer Foundation Young Investigator Award 2013,the National Natural Science Foundation of China(Grant Nos.81300627,81200551,81270841,81460148,81500522 and 81370855);Programs from Science and Technology Department of Sichuan Province(Grant Nos.2013SZ0006 and 2014JY0219);International Cooperation Fund of Sichuan Science and Technology Program(2017HH0063);China Postdoctoral Science Foundation(2017M612971).

摘　　要：Objective:To compare these managements focusing on the efficacy and safety to treat overactive bladder(OAB)in children through network meta-analysis(NMA).Methods:We searched PubMed,Embase,the Cochrane Library Central Register of Controlled Trials(CENTRAL)and the reference lists up to May 1st,2017.Data from eligible randomized controlled trails(RCT)studies including three different treatment options were extracted.The primary outcome was maximal voiding volume(MVV).We performed pairwise metaanalyses by random effects model and NMA by Bayesian model.We used the Grading of Recommendations,Assessment,Development and Evaluations(GRADE)framework to assess the quality of evidence contributing to each network estimate.Results:Six RCTs(462 patients)comparing three different interventions fulfilled the inclusion criteria.A low risk of bias was shown for the majority of the study items.The results of NMA showed that compared with antimuscarinic drugs,Parasacral transcutaneous electrical nerve stimulation was associated with significant improvement in the MVV(mean difference[MD]=58.50,95% confidential interval[CI]:45.95-69.52),followed by urotherapy group(MD=21.03,95%CI:11.85-29.97).When it comes to the constipation,antimuscarinic drugs exerted significant benefit than PTENS(odds ratio[OR]:0.22,95%CI:0.01-0.46).No significant difference was found between other treatments.Conclusion:Compared with antimuscarinic drugs,PTENS was associated with significant better efficacy considering MVV,but more constipation events in de novo OAB children.Antimuscarinic drugs showed remarkably better efficacy considering MVV and comparable safety profile compared with urotherapy.Clinicians should take all known safety and compliance of patients into account when choosing an optimal strategy.

关 键 词：Overactive bladder META-ANALYSIS ANTICHOLINERGICS Parasacral transcutaneous electrical nerve stimulation 

分 类 号：R69[医药卫生—泌尿科学]