Mirabegron: A Beta-3 Agonist for Overactive Bladder

Bragg, Rebecca; Hebel, Danielle; Vouri, Scott Martin; Pitlick, Jamie M.

doi:10.4140/tcp.n.2014.823

Cited by 54 publications

(29 citation statements)

References 27 publications

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“…37 As part of a newer class of agents, mirabegron stimulates β-3 adrenergic receptors to relax bladder smooth muscle and achieve the same effect as the anticholinergics. 38 These medications can increase PVR urine volume, so patients should be monitored for the development of retention and need to perform CIC.…”

Section: Failure To Storementioning

confidence: 99%

Voiding Dysfunction in Multiple Sclerosis

et al. 2016

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Voiding dysfunction is a common and debilitating consequence of multiple sclerosis (MS). The prevalence and severity of voiding dysfunction increases with the increasing severity of MS, but even the mildest forms of the disease are associated with urinary symptoms in 30% of patients. Every component of the central nervous system is involved in regulating voiding; as a result, MS can lead to a wide variety of urinary symptoms and urologic complications. The effect of MS on voiding can be classified according to the resulting function of the bladder and the urethral sphincter during storage and emptying of urine. Therapy is targeted to the specific bladder and sphincter abnormalities that occur. The primary goals of therapy are prevention of injury to the upper urinary tract (kidneys), reduction in urinary tract infections, and maintenance of urinary continence. These goals can be achieved by interventions ranging from behavioral modification to major reconstructive surgery.

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Section: Failure To Storementioning

confidence: 99%

Voiding Dysfunction in Multiple Sclerosis

et al. 2016

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“…8,9 Similarly, adrenergic receptors are also located throughout the body with resultant side effects, especially important being cardiovascular effects. 10 While more targeted than the systemic approach with potentially fewer side effects, OnabotulinumtoxinA injections provide a minimally invasive treatment that needs to be repeated to maintain clinical efficacy. 11 While potentially more durable, the MIS procedure involves an invasive surgery with more tissue disruption, longer recovery time, and potential for interprocedural variations.…”

Section: Introductionmentioning

confidence: 99%

Selective bladder denervation for overactive bladder (OAB) syndrome: From concept to healing outcomes using the ovine model

Fugett

Phillips²,

Tobin³

et al. 2018

Neurourology and Urodynamics

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Aims: We evaluated a Selective Bladder Denervation (SBD) device, which uses radiofrequency ablation, for the treatment of overactive bladder syndrome in terms of its nerve denervation, ablation characteristics, and post-treatment healing. Methods: Using the SBD device, eight fresh extirpated ovine bladder trigones were treated (90°C set point for 60 s) and nitroblue tetrazolium viability stained to characterize the ablation. In addition, 12 trigones were treated in vivo with three adjacent ablations and divided into survival cohorts: Day 7, Day 30, and Day 90 to assess the ablations and their associated healing. Results: The ex vivo single trigone ablations had a 7.9 ± 0.9 mm width and 5.7 ± 1.0 mm thickness that involved the submucosa, detrusor muscle, adventitia, and vagina. Microscopic viability staining confirmed complete nerve necrosis within the targeted tissue. The in vivo Day 7 trigones supported the ex vivo ablation characteristics and showed up to minimal inflammation, granulation tissue, and collagen fibrosis. Day 30 trigones had essentially absent inflammation and granulation tissue with evolving collagen fibrosis at the ablation's periphery. Day 90 trigones had essentially absent acute inflammation, minimal chronic inflammation, essentially absent granulation tissue, and up to mild collagen fibrosis. No ureteral/urethral alterations, vesico-vaginal fistulas, or other complications were identified. Conclusions: The SBD device provided a targeted trigone ablation with resultant denervation. The tissue healing timeline followed that expected for a hyperthermic ablation and was characterized by a fibroproliferative healing response with limited inflammation and granulation tissue. The ablations did not impact the overlying bladder mucosal surface.

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“…Mirabegron targets the β3‐adrenoceptor, causing direct relaxation of the detrusor muscle, inhibition of spontaneous contractile activity in the bladder, and reduction in bladder afferent activity 20 . ‐ 22 Pooled analysis of published studies showed that mirabegron 50 mg was associated with a reduction in mean micturition per 24 hours and incontinence episodes per 24 hours 21 . Mirabegron is well tolerated, with negligible dry mouth; however, there is an increase in cardiovascular events (most commonly hypertension) associated with its use 20 .…”

Section: Stepwise Approach To Treatment Optionsmentioning

confidence: 99%

Position statement: a clinical approach to the management of adult non‐neurogenic overactive bladder

Chung

Lee

Gani

et al. 2018

Medical Journal of Australia

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Overactive bladder (OAB) is a highly prevalent medical condition that has an adverse impact on various health-related quality-of-life domains, including a significant psychosocial and financial burden. This position statement, formulated by members of the Urological Society of Australia and New Zealand and the UroGynaecological Society of Australasia, summarises the current recommendations for clinical diagnosis and treatment strategies in patients with non-neurogenic OAB, and guides clinicians in the decision-making process for managing the condition using evidence-based medicine. Main recommendations: Diagnosis and initial management should be based on thorough clinical history, examination and basic investigations to exclude underlying treatable causes such as urinary tract infection and urological malignancy. Initial treatment strategies for OAB involve conservative management with behavioural modification and bladder retraining. Second-line management involves medical therapy using anticholinergic or β3 agonist drugs provided there is adequate assessment of bladder emptying. If medical therapy is unsuccessful, further investigations with urodynamic studies and cystourethroscopy are recommended to guide further treatment. Intravesical botulinum toxin and sacral neuromodulation should be considered in medical refractory OAB. Changes in management as a result of this statement: OAB is a constellation of urinary symptoms and is a chronic condition with a low likelihood of cure; managing patient expectations is essential because OAB is challenging to treat. At present, the exact pathogenesis of OAB remains unclear and it is likely that there are multiple factors involved in this disease complex. Current medical treatment remains far from ideal, although minimally invasive surgery can be effective. Further research into the pathophysiology of this common condition will hopefully guide future developments in disease management.

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Mirabegron: A Beta-3 Agonist for Overactive Bladder

Cited by 54 publications

References 27 publications

Voiding Dysfunction in Multiple Sclerosis

Voiding Dysfunction in Multiple Sclerosis

Selective bladder denervation for overactive bladder (OAB) syndrome: From concept to healing outcomes using the ovine model

Position statement: a clinical approach to the management of adult non‐neurogenic overactive bladder

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