Effectiveness and persistence of mirabegron as a first‐line treatment in patients with overactive bladder in real‐life practice

Abstract

Objectives: To evaluate the effectiveness and persistence of mirabegron as a first-line treatment in patients with overactive bladder (OAB) in real-life practice. Methods:We retrospectively analyzed patients with OAB who received mirabegron (50 mg) as a first-line treatment. According to treatment course, patients were divided into three groups, (a) mirabegron only (monotherapy group), (b) mirabegron and anticholinergics (add-on group), and (c) mirabegron replaced with another treatment (switch group). The patients' symptoms were documented with a voiding diary including an urgency scale and a patient perception of treatment benefit questionnaire (PPTB). Follow-up was at 4 weeks after initial treatment and then 2 months later, according to our routine protocol.Results: A total of 196 patients were included: 128 patients (65.3%) received monotherapy and 60 patients (30.6%) received add-on therapy. Eight patients discontinued mirabegron and switched to another treatment modality. The add-on group had more episodes of baseline urinary frequency, nocturia and urgency than the monotherapy group (P = 0.011, 0.001, and 0.006, respectively). In the monotherapy group, mean daily frequency, nocturia, urgency episodes, and urgency urinary incontinence were improved (P < 0.05) after mirabegron treatment.The persistence of mirabegron monotherapy was 68.0% at 3 months, 54.4% at 6 months, and 39.4% at 12 months. Treatment-naïve patients had better persistency than previously anticholinergics-treated patients. Conclusions:Mirabegron is an effective first-line therapy for OAB, but has a persistence rate of 39.4% at 12 months. Patients with severe baseline OAB symptoms tended to require add-on therapy during follow-up.

Persistence with mirabegron or antimuscarinic treatment for overactive bladder syndrome: Findings from the PERSPECTIVE registry study

“…The previous studies were database analyses, while the present study was a clinical practice investigation. In support of this hypothesis, a retrospective, real‐life study found that treatment‐naïve patients persisted with mirabegron treatment longer than patients who had received previous anticholinergic therapy 38 …”

“…In support of this hypothesis, a retrospective, real‐life study found that treatment‐naïve patients persisted with mirabegron treatment longer than patients who had received previous anticholinergic therapy. 38 …”

Mirabegron has longer treatment persistence than antimuscarinics: Real‐world data from a Korean national cohort database

“…Again, this finding may be due to the fact that treatment‐experienced patients will be more familiar with the potential therapeutic benefits that can be achieved by taking OAB medication consistently. In contrast, a South Korean practice study found that treatment‐naïve patients persisted with mirabegron treatment longer than those who had received previous anticholinergic therapy 25 …”

“…In contrast, a South Korean practice study found that treatment-naïve patients persisted with mirabegron treatment longer than those who had received previous anticholinergic therapy. 25 Regardless of the subgroup, mirabegron was associated with longer persistence compared with all of the antimuscarinics investigated. In agreement with our findings, most of the studies that have investigated persistence according to specific subgroups found that mirabegron was associated with longer persistence than antimuscarinics regardless of the sex, age, or treatment status of the patients.…”

Overactive bladder and sleep disturbance have a significant effect on indoor falls: Results from the community health survey in Japan

“…3,6 According to the increasing interest in the association of aging with frailty, many researchers have suggested the clinical implication of frailty in several diseases. [7][8][9] Lower urinary tract symptoms including overactive bladder (OAB) are common urologic disorders in the elderly [10][11][12][13][14][15][16][17][18][19][20] and several studies have suggested an association of falls with OAB. 21 The OAB symptoms are the leading causes of sleep disturbance 13,22,23 and are associated with frailty.…”