Long-Term Efficacy of Mirabegron Add-On Therapy to Antimuscarinic Agents in Patients With Spinal Cord Injury

Han, Seok Hee; Cho, In Kyoung; Jung, Joo Hwan; Jang, Seong Ho; Lee, Bum Suk

doi:10.5535/arm.2019.43.1.54

Cited by 9 publications

(3 citation statements)

References 27 publications

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“…Early studies suggest that mirabegron is effective and well tolerated in neurological patients [28], however data in patients with TBI is lacking. The combination of an antimuscarinic agent with a b3 agonist appears has been shown to be effective in patients refractory to antimuscarinic agents alone [29].…”

Section: Treatmentmentioning

confidence: 99%

Urogenital dysfunction following neurotrauma

Saraf

Panicker

2022

Current Opinion in Neurology

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Purpose of reviewTrauma affecting the nervous system can have widespread consequences, depending on the location and severity of injury. The sensorimotor and cognitive deficits due to neurotrauma have been studied extensively. Although the overall mortality due to neurotrauma has reduced, the disability and morbidity due to neurotrauma has not significantly reduced and focus on urogenital disturbances in these patients has been limited. This article reviews the limited evidence and scientific literature on this topic. Recent findingsLower urinary tract symptoms are commonly reported in patients with neurotrauma, both acutely and over the long term. Multiple medical and surgical approaches are available for managing bladder dysfunction in these patients. Sexual dysfunction and changes in sexual behaviour are reported by patients with neurotrauma and are usually multifactorial. Treatment options for sexual dysfunction are available and their management requires a holistic approach. SummaryUrogenital dysfunction contributes significantly to the overall functional outcome and impaired quality of life in patients with neurotrauma. A better understanding of the mechanisms behind the urogenital abnormalities is needed for efficient management and treatment.

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Section: Treatmentmentioning

confidence: 99%

Urogenital dysfunction following neurotrauma

Saraf

Panicker

2022

Current Opinion in Neurology

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“…One study in chronic patients with SCI demonstrated that adding mirabegron to traditional antimuscarinic therapy resulted in long-term improvements to bladder capacity and compliance when compared with antimuscarinic therapy alone. 20…”

Section: Managementmentioning

confidence: 99%

Bowel and Bladder Care in Patients With Spinal Cord Injury

Kuris

Alsoof

Osorio

et al. 2021

J Am Acad Orthop Surg

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Complete and incomplete spinal cord injuries affect between 250,000 and 500,000 people on an annual basis worldwide. In addition to sensory and motor dysfunction, spinal cord injury patients also suffer from associated conditions such as neurogenic bowel and bladder dysfunction. The degree of dysfunction varies on the level, degree, and type of spinal cord injury that occurs. In addition to the acute surgical treatment of these patients, spine surgeons should understand how to manage neurogenic bowel and bladder care on both a short-and longterm basis to minimize the risk for complications and optimize potential for rehabilitation. Spinal cord injury (SCI) is a devastating incident that results from traumatic and nontraumatic events leading to spinal cord damage. 1 Leading causes include vehicular accidents, falls, violence (gun-shot injuries), sport-related, and medical or surgical complications. 2 The National Spinal Cord Injury Statistical Center indicates an incidence of 17,810 new cases each year in the United States, with a mean hospital stay length of 11 days. Worldwide, the incidence ranges from 250,000 to 500,000 persons per year.Since 2005, the average age at injury is 40.7 years. Although the life expectancy of SCI has improved dramatically since the 1950s, it remains below the cohort average. 3 After a SCI, the average life expectancy when compared with the general cohort ranges from 18.1% to 88.4% because of factors including age, sex, and the neurologic grouping of injury-with better prognosis in incomplete spinal cord lesions. 3 Incomplete quadriplegia is the most frequent form of SCI (47.2%), followed by complete paraplegia (20.2%), incomplete paraplegia (19.6%), and complete quadriplegia (12.3%). Under 1% of patients will experience complete neurologic recovery by the time of hospital discharge. 2 Bowel and bladder dysfunction have a devastating impact on the quality of life after SCI. Approximately 30% of patients recovering from a SCI are hospitalized on an annual basis, with genitourinary infections the most common cause of readmission (23.5 to 29.8%) and the fifth most common cause of death. Bowel dysfunction is the most reported report with an incidence between 20 and 60% and the ninth most common reason for rehospitalization. 4 The challenges of bowel and bladder dysfunction affect the daily

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“…The use of mirabegron is currently limited in neurogenic bladder patients, as limited evidence exists to support its use in this population [8,31] . It might be considered as an alternative in patients with contraindication to using anticholinergics, or as an add-on treatment to anticholinergics [35,36] . Table 3.…”

Section: Systemic Medications To Treat Neurogenic Detrusor Over-activitymentioning

confidence: 99%

Evaluation, treatment, and surveillance of neurogenic detrusor overactivity in spinal cord injury patients

Alsulihem¹,

Corcos²

2019

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Neurogenic detrusor overactivity is a common urodynamic finding in patients with supra-sacral spinal cord injury. Early evaluation, stepped management, and close follow-up reduce the risk of upper urinary tract deterioration, renal failure and incontinence. In this article, we aim to outline the modern pathway of the management of this complex disease. Evaluation of patients with history, physical examination, renal function assessment, cystoscopy, and urodynamic study are essential. Management of neurogenic detrusor overactivity with adequate bladder drainage, medical therapy, intradetrusor botulinum injections, and surgery can be offered in a stepwise manner. Follow-up after specific interventions should be done in a timely fashion to detect treatment response and to avoid complications of poorly managed neurogenic detrusor overactivity.

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Long-Term Efficacy of Mirabegron Add-On Therapy to Antimuscarinic Agents in Patients With Spinal Cord Injury

Cited by 9 publications

References 27 publications

Urogenital dysfunction following neurotrauma

Urogenital dysfunction following neurotrauma

Bowel and Bladder Care in Patients With Spinal Cord Injury

Evaluation, treatment, and surveillance of neurogenic detrusor overactivity in spinal cord injury patients

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