Systematic review and meta‐analysis on the efficacy and tolerability of mirabegron for the treatment of storage lower urinary tract symptoms/overactive bladder: Comparison with placebo and tolterodine

Abstract

A systematic review and meta-analysis was carried out to evaluate the efficacy and safety of mirabegron 50 mg and 100 mg in the treatment of storage lower urinary tract symptoms/overactive bladder in comparison with a placebo and tolterodine 4 mg. A total of 491 articles were collected and eight randomized studies were identified as eligible for this meta-analysis. Overall, eight trials were included in the meta-analysis evaluating 10 248 patients. Mirabegron at both doses of 50 mg and 100 mg, and and tolterodine 4 mg were significantly associated with the reduction of incontinence episodes per 24 h, reduction of mean number of micturitions per 24 h, increase of voided volume and reduction of urgency episodes per 24 h, compared to a placebo. Both mirabegron 50 mg and mirabegron 100 mg were associated with a significant reduction of nocturia episodes when compared with a placebo. Conversely, tolterodine 4 mg did not prove to be more effective than a placebo in the reduction of nocturia episodes. Furthermore, mirabegron 50 mg showed a slightly, but significantly, better efficacy than tolterodine 4 mg in the improvement of nocturia episodes. Mirabegron 50 mg and mirabegron 100 mg shared the same risk of overall treatmentemergent adverse events rate with the placebo. Otherwise, tolterodine 4 mg was associated with a significantly greater risk than the placebo. However, mirabegron 100 mg showed a slight trend toward an increased risk of hypertension (odds ratio 1.41; P = 0.08) and cardiac arrhythmia (odds ratio 2.18; P = 0.06). Mirabegron is an effective treatment for patients with storage lower urinary tract symptoms/overactive bladder, providing a reduction of incontinence, urgency and frequency; an improvement of voided volume with a slight, but statistically, significant improvement of nocturia; with a good safety profile. These findings should be considered for the treatment planning of patients with storage lower urinary tract symptoms/overactive bladder.

Safety and Efficacy of Mirabegron: Analysis of a Large Integrated Clinical Trial Database of Patients with Overactive Bladder Receiving Mirabegron, Antimuscarinics, or Placebo

“…Mirabegron, a b3-adrenoreceptor agonist, is an alternative treatment option to antimuscarinics for overactive bladder (OAB) symptoms [1], with established efficacy and safety profiles [2,3]. To support and further characterise safety and efficacy reporting for adult patients receiving mirabegron monotherapy, data from global double-blind, 12-wk studies in patients with OAB [4][5][6][7][8][9][10][11][12][13] were pooled.…”

Relationship between frailty and lower urinary tract symptoms among community‐dwelling adults

“…Lower urinary tract symptoms (LUTS) are among the most common urologic conditions in the older population . As the incidence of LUTS and frailty increases with age, the concept of frailty has been recognized as a key factor in older individuals with LUTS . However, only a few studies have evaluated the influence of frailty on LUTS .…”

Can mirabegron facilitate ureteral access sheath placement during flexible ureterorenoscopy?

“…Mirabegron increases the capacity of the bladder by relaxing mechanism and affecting its filling function without affecting its contractility or flow rates [10,11]. Animal experiments have also demonstrated dilatation of the ureter and a decrease in ureteral intraluminal pressure with the use of mirabegron [12]. In addition, it has been reported to be an effective and safe medical expulsive treatment agent for the reduction of distal ureteral stones with a low rate of side effects [4,14].…”