Comparisons of the Clinical Outcomes and Urodynamic Effects of Mirabegron versus Tolterodine Treatment for Female Overactive Bladder Syndrome: A Subgroup Analysis of a Controlled, Randomised, Prospective Study

Hsiao, Sheng‐Mou; Chang, Ting-Chen; Chen, Chi-Hau; Wu, Wen-Yih; Lin, Ho‐Hsiung

doi:10.1111/luts.12167

Cited by 8 publications

(7 citation statements)

References 35 publications

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“…However, no significant increase in PVR was observed in the mirabegron group. Hence, as reported previously, mirabegron might be relatively safer than anticholinergic medications for patients with lower urinary tract function (13)(14)(15)(16).…”

Section: Discussionsupporting

confidence: 60%

Effects of β3 Agonists and Anticholinergic Drugs on Defecation in Patients With Overactive Bladder

Ito

Matsuo

Kurata

et al. 2022

In Vivo

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Background/Aim: In clinical practice, constipation is one of the most frequent adverse events caused by drugs for overactive bladder (OAB). The occurrence of constipation greatly deteriorates the patient's quality of life. The aim of the study was to evaluate and compare the effects of three commonly used β3 agonists and anticholinergic drugs on the defecation status in patients with OAB. Patients and Methods: We retrospectively reviewed the defecation status in patients who received mirabegron, solifenacin, or fesoterodine for OAB. We evaluated changes in the (a) urological parameters using the OAB symptom score (OABSS) and (b) defecation status using the Bristol Stool Form Scale (BSFS) and constipation scoring system (CSS) following 12 weeks of drug administration. Results: We analyzed data from 165 patients (mirabegron=56, fesoterodine=52, and solifenacin=57). The solifenacin group showed a significant decrease in BSFS (from 3.2±1.0 at baseline to 2.3±1.2 post-treatment) and an increase in hardened stools (p<0.001). Elimination worsened as assessed by almost all items, and the total modified CSS scores worsened significantly from 4.8±2.6 points at baseline to 8.0±4.8 points after 12 weeks of solifenacin treatment (p<0.001). The mirabegron group showed no changes in any of the CSS items. In the fesoterodine group, the CSS scores for "completeness" and "assistance" increased significantly after treatment (p<0.001 and p=0.013, respectively). Conclusion: All three drugs were effective for OAB. Mirabegron had almost no effect on constipation; fesoterodine, an anticholinergic drug, also had hardly any effect on defecation.Overactive bladder (OAB) is a symptom syndrome characterized by urinary urgency, with or without urgency incontinence (1). The prevalence of OAB increases with age, and some epidemiological surveys suggest it to be 16-19% (2, 3). β3-adrenergic receptor agonists and anticholinergic drugs are standard drug therapies for OAB worldwide. However, the persistence of drugs for OAB is lower than that of drugs for chronic diseases such as hypertension and diabetes (4). Furthermore, compared to β3-adrenergic receptor stimulants, anticholinergic drugs have a significantly lower continuation rate due to adverse events associated with them in the early phase of administration (5).The adverse events associated with anticholinergic drugs include dry mouth, constipation, dementia, and dysuria. Among them, constipation has the greatest effect on patient satisfaction (6). While there are several meta-analyses on the risk of constipation associated with β3 adrenergic receptor agonists and anticholinergic drugs (7, 8), there are no detailed studies on the changes in the defecation status before and after the administration of these drugs.This study aimed to examine the differences in defecation status before and after administration of β3 agonists and anticholinergic drugs using an established questionnaire. Patients and MethodsEthics. The study protocol was approved by the Clinical Study Review Board of the Nagasaki ...

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Section: Discussionsupporting

confidence: 60%

Effects of β3 Agonists and Anticholinergic Drugs on Defecation in Patients With Overactive Bladder

Ito

Matsuo

Kurata

et al. 2022

In Vivo

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“…From spinal cord these afferent signals ascend to pontine micturition center and cerebrum. Once a voluntary decision to pass urine is made, the pontine center [34] Evaluation This study concludes that addition of Mirabegron has widened therapeutic approach in treatment of OAB. However, it does recommend that each patient needs to be tailored for specific treatment strategy.…”

Section: Discussionmentioning

confidence: 88%

Comparison of antimuscarinic drugs to beta adrenergic agonists in overactive bladder: A literary review

Wani¹,

Sheikh²,

Bhat³

et al. 2021

Current Urology

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Background: The purpose of this study was to carry an extended literature review to compare antimuscarnics with beta adrenergic agonists (mirabegron) in treatment of overactive bladder. Materials and methods: A literature review was carried out, using key words in different databases including MEDLINE, PUBMED, and EMBASE. All relevant published articles during last 5 years with full texts available were included in this review for critical analysis and evaluation. In total, there were 20 studies including 7 systemic reviews, 6 retrospective cohort, 3 prospective cohort, 2 randomized controlled trials, and 2 cross sectional studies. Results: After critical evaluation the results were considered under parameters of efficacy, adverse effects, adherence and persistence, tolerability, cost-effectiveness. In 9 studies efficacy was evaluated, 5 studies dealt with adverse effects, same number evaluated adherence and persistence. Cost effectiveness was compared in 3 and same number of studies also compared tolerability. Conclusions: To conclude, we found mirabegron is as efficacious as any other antimuscarnics, has better tolerability (including elderly), has better adverse effect profile, is cost effective, has better persistence and adherence rates at 12 months.

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“…1 ). 8 9 10 11 12 13 14 15 16 17 18 19 20 21 Chart 1 describes the main characteristics of the included studies. A total of 6 studies with 5,535 patients, compared mirabegron (25–50mg) to solifenacin (2.5mg-5mg-10mg) 12 13 16 17 19 21 and 8 studies with 5,239 patients, compared mirabegron (25–50mg) to tolterodine ER 4mg.…”

Section: Resultsmentioning

confidence: 99%

Mirabegron and Anticholinergics in the Treatment of Overactive Bladder Syndrome: A Meta-analysis

Sartori

Nunes

Farah

et al. 2023

Rev Bras Ginecol Obstet

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Objective To compare the use of mirabegron with anticholinergics drugs for the treatment of overactive bladder (OB). Data Source Systematic searches were conducted in EMBASE, PUBMED, Cochrane, and LILACS databases from inception to September 2021. We included RCTs, women with clinically proven OB symptoms, studies that compared mirabegron to antimuscarinic drugs, and that evaluated the efficacy, safety or adherence. Data Collection RevMan 5.4 was used to combine results across studies. We derived risk ratios (RRs) and mean differences with 95% CIs using a random-effects meta-analytic model. Cochrane Collaboration Tool and GRADE was applied for risk of bias and quality of the evidence. Data Synthesis We included 14 studies with a total of 10,774 patients. Fewer total adverse events was reported in mirabegron group than in antimuscarinics group [RR 0.93 (0.89–0.98)]. The risk of gastrointestinal tract disorders and dry mouth were lower with mirabegron [RR 0,58 (0.48–0.68); 9375 patients; RR 0.44 (0.35–0.56), 9375 patients, respectively]. No difference was reported between mirabegron and antimuscarinics drugs for efficacy. The adherence to treatment was 87.7% in both groups [RR 0.99 (0.98–1.00)]. Conclusion Mirabegron and antimuscarinics have comparable efficacy and adherence rates; however, mirabegron showed fewer total and isolated adverse events.

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Comparisons of the Clinical Outcomes and Urodynamic Effects of Mirabegron versus Tolterodine Treatment for Female Overactive Bladder Syndrome: A Subgroup Analysis of a Controlled, Randomised, Prospective Study

Abstract: Mirabegron and tolterodine exhibit similar changes in the urodynamics and bladder diary parameters. However, mirabegron may decrease the total voided volume. These findings may serve as an initial guide or assist in consultations regarding the treatment of OAB patients with mirabegron.

Cited by 8 publications

References 35 publications

Effects of β3 Agonists and Anticholinergic Drugs on Defecation in Patients With Overactive Bladder

Effects of β3 Agonists and Anticholinergic Drugs on Defecation in Patients With Overactive Bladder

Comparison of antimuscarinic drugs to beta adrenergic agonists in overactive bladder: A literary review

Mirabegron and Anticholinergics in the Treatment of Overactive Bladder Syndrome: A Meta-analysis

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