Mirabegron is alternative to antimuscarinic agents for overactive bladder without higher risk in hypertension: a systematic review and meta-analysis

Chen, Hsiao‐Ling; Chen, Tun‐Chieh; Chang, Hsiu-Mei; Juan, Yung‐Shun; Huang, Wei-Chieh; Pan, Hung-Fang; Chang, Yu-Tang; Wu, Chiou-Mei; Wang, Yaling; Lee, Hsiang Ying

doi:10.1007/s00345-018-2268-9

Cited by 20 publications

(19 citation statements)

References 17 publications

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“…However, meta-analyses have not demonstrated an increased risk of cardiovascular complications for mirabegron compared to placebo. [9][10][11]26 Furthermore, the incidence of antimuscarinic side effects is lower for mirabegron, and thus, tolerability is better compared to antimuscarinics. 10,26,27 In the present investigation, four patients (6%) had reported side effects, such as tachycardia, stomach pain or headache.…”

Section: Discussionmentioning

confidence: 99%

<p>Real-World Effects of Mirabegron in Patients with Chronic Neurogenic Detrusor Overactivity – A Retrospective Cohort Study</p>

Krebs

Pannek

Rademacher

et al. 2020

RRU

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Purpose: To investigate the tolerability and the effects of the β-3-adrenoceptor-agonist mirabegron on urinary incontinence and urodynamic parameters in patients with chronic neurogenic detrusor overactivity (NDO). Patients and Methods: The patient database of a spinal cord injury rehabilitation center in Switzerland was screened for patients with chronic (>12 months) NDO, who had been prescribed mirabegron. Patient characteristics, data regarding bladder management, urinary incontinence and concurrent medication for NDO as well as urodynamic parameters were collected retrospectively. The changes in the urodynamic parameters and the occurrence of urinary incontinence over time were investigated. Results: The data of 63 patients with a median age of 48 years and a median NDO duration of 8.9 years at the initiation of the mirabegron treatment were analyzed. A median 3.0 and 12.7 months had elapsed from the initiation of the mirabegron therapy to the first and second follow-up evaluation, respectively. The majority of patients (73%) received mirabegron in combination with an established antimuscarinic or onabotulinum toxin therapy. The number of patients suffering from urinary incontinence decreased significantly (p≤0.005) from 60.3% (95% CI 47.2/72.4%) to 38.1% (95% CI 23.6/54.4%). Furthermore, the maximum detrusor pressure during the storage phase was significantly (p≤0.04) lower at the second follow-up evaluation (29.5cmH 2 O, 95% CI 22/40cmH 2 O) compared to before the mirabegron treatment (35cmH 2 O, 95% CI 29/41cmH 2 O). The bladder capacity and detrusor compliance were significantly (p≤0.005) increased during the mirabegron treatment. No patient had discontinued the mirabegron treatment as a result of side effects. Conclusion: Mirabegron demonstrated a clinically relevant effect and a good safety profile. Concomitant treatment of NDO with mirabegron may allow reduction in the dose of antimuscarinic medication and thus, improve the long-term persistence of NDO treatment.

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Section: Discussionmentioning

confidence: 99%

<p>Real-World Effects of Mirabegron in Patients with Chronic Neurogenic Detrusor Overactivity – A Retrospective Cohort Study</p>

Krebs

Pannek

Rademacher

et al. 2020

RRU

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“…In a study examining the safety profile of mirabegron, there was a slight increase in hypertension with this drug compared with placebo and only among individuals over 75 (7% versus 5%) [45]. The absence of hypertension risk has also been reaffirmed on meta-analysis [46]. In an observational study from the UK, improvements in both quality of life and health status were seen for patients on mirabegron, with over 50% persisting on the drug at 12 months [47].…”

Section: Beta-3 Agonistsmentioning

confidence: 99%

Overactive Bladder: Where We Are and Where We Are Going

Mohan¹,

Lee²,

Kobashi³

2021

Société Internationale D’Urologie Journal

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Overactive bladder (OAB) is a heterogeneous syndrome estimated to affect approximately 10% to 15% of men and women globally. OAB not only negatively impacts quality of life but also results in a significant financial burden to both patients and health systems. Therefore, it is crucial that OAB is properly addressed. This manuscript provides a general review of the diagnostic algorithm for OAB and treatment per the AUA/SUFU guidelines, and an overview of new developments in OAB therapy. Given the wide array of therapeutic options that currently exist and those that are currently under development, there is tremendous opportunity to treat OAB successfully and positively affect our patients’ lives.

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“…This systematic review focused on studies of adult women with stress urinary incontinence (SUI), urgency urinary incontinence (UUI), or mixed urinary incontinence (MUI); women were excluded if they were pregnant or hospitalized. We updated this review with additional studies published since August 2018 [118][119][120][121][122][123][124].…”

Section: Urinary Incontinencementioning

confidence: 99%

“…Based on this recent systematic review, six additional studies [118][119][120][121][122][123][124], and expert consensus:…”

Section: Urinary Incontinencementioning

confidence: 99%

A guide for urogynecologic patient care utilizing telemedicine during the COVID-19 pandemic: review of existing evidence

et al. 2020

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Introduction and hypothesis The COVID-19 pandemic and the desire to "flatten the curve" of transmission have significantly affected the way providers care for patients. Female Pelvic Medicine and Reconstructive Surgeons (FPMRS) must provide high quality of care through remote access such as telemedicine. No clear guidelines exist on the use of telemedicine in FPMRS. Using expedited literature review methodology, we provide guidance regarding management of common outpatient urogynecology scenarios during the pandemic. Methods We grouped FPMRS conditions into those in which virtual management differs from direct in-person visits and conditions in which treatment would emphasize behavioral and conservative counseling but not deviate from current management paradigms. We conducted expedited literature review on four topics (telemedicine in FPMRS, pessary management, urinary tract infections, urinary retention) and addressed four other topics (urinary incontinence, prolapse, fecal incontinence, defecatory dysfunction) based on existing systematic reviews and guidelines. We further compiled expert consensus regarding management of FPMRS patients in the virtual setting, scenarios when in-person visits are necessary, symptoms that should alert providers, and specific considerations for FPMRS patients with suspected or confirmed COVID-19. Results Behavioral, medical, and conservative management will be valuable as first-line virtual treatments. Certain situations will require different treatments in the virtual setting while others will require an in-person visit despite the risks of COVID-19 transmission.Conclusions We have presented guidance for treating FPMRS conditions via telemedicine based on rapid literature review and expert consensus and presented it in a format that can be actively referenced.

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Mirabegron is alternative to antimuscarinic agents for overactive bladder without higher risk in hypertension: a systematic review and meta-analysis

Cited by 20 publications

References 17 publications

<p>Real-World Effects of Mirabegron in Patients with Chronic Neurogenic Detrusor Overactivity – A Retrospective Cohort Study</p>

<p>Real-World Effects of Mirabegron in Patients with Chronic Neurogenic Detrusor Overactivity – A Retrospective Cohort Study</p>

Overactive Bladder: Where We Are and Where We Are Going

A guide for urogynecologic patient care utilizing telemedicine during the COVID-19 pandemic: review of existing evidence

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