Experience of using a drug containing polypeptides of the bladder of cattle in the treatment of patients with overactive bladder in perimenopause

Overactive bladder (OAB) is a chronic syndrome that dramatically reduces the quality of life.In addition to the traditional use of a number of M-anticholinergics and a selective β3-adrenoreceptor agonists for the treatment of OAB, information has appeared about the results of experimental studies that have established the key mechanism of action of short-chain peptide bioregulators, which consists in regulating the expression of protein synthesis genes and is realized through a cascade of peptide signals. In recent years, the results of clinical use of the drug for the treatment of patients with OAB have been published. Such a drug is vezusten, created on the basis of regulatory peptides with a molecular weight of no more than 10 kDa, obtained from the tissue of the bladder of bulls. Material and methods. We present the results of an observational study of the efficacy and safety of the drug �Vezusten� in the treatment of patients with OAB in perimenopause. 70 patients with symptoms of OAB were examined. Patients of the 1st group (n=35) received bladder polypeptides — vesusten 5 mg intramuscularly 3 times a week, the course of therapy was 10 injections. Patients of the 2nd group (n=35) received a β3-adrenergic receptor agonist — mirabegron (betmiga) 50 mg per day for 3 months. Efficiency was assessed by using questionnaires (ICiQ-SF, OABSS scale), evaluating urination diaries, examination, and conducting functional tests (Valsalva maneuver, cough test). Results. The average age of the study participants was 46.9±2.3 years. The main urination disorders were: frequent urination in 88.6%, nocturia — 78.6%, urgent urge to urinate — 100%, urgent urinary incontinence — 11.4%, the groups were comparable in terms of initial symptoms. After 1 month from the start of the study, in the 1st group there was a decrease in pollakiuria by 43.75% and nocturia by 39.29% (p<0.05). Positive dynamics were noted in patients with urgency: a decrease in the number of patients with urgent urinations by 51.43% and a decrease in urgent urinary incontinence by 25%, p<0.05. In the 2nd group after 1 month from the start of the study (1 month of continuous therapy with Mirabegron), there was also a decrease in the number of patients with pollakiuria (by 43.33%), with nocturia (by 40.74%), p<0.05. Urgency decreased by 54.29%, urgent urinary incontinence by 50% (p<0.05). After 3 months from the start of the study, patients in both groups showed significant clinical improvement: the number of patients with pollakiuria decreased by 96.88% in group 1 and by 90% in group 2 compared to baseline; with nocturia — by 89.29% and 85.19%; with urgency — by 97.14% and 91.43%. After 6 months. from the beginning of the study, a more pronounced remission was noted in the group of patients receiving vesusten: a persistent decrease in pollakiuria, nocturia and urgency for 5.8 months after the course of therapy, whereas in the group of patients using mirabegron at a dose of 50 mg, in 50% of patients the symptoms returned after a period of less than 3 months after the discontinuation of therapy. Conclusion. The use of a drug created on the basis of regulatory peptides obtained from the bladder tissue of bulls in patients with OAB during perimenopause is effective and comparable in the effectiveness of therapy with β3-adrenergic receptor agonists. The advantage of using polypeptide therapy is a pronounced decrease in the main symptom of OAB — urgent urinary incontinence and the duration of the relapse-free period, which allows for intervals in treatment of up to 6 months, and possibly more (requires further clarification studies).