Effectiveness and tolerability of mirabegron in children with overactive bladder: A retrospective pilot study

Fryer, Samantha; Nicoara, Cezar Doru; Dobson, Emily; Griffiths, Megan; McAndrew, H.F.; Kenny, Simon E.; Corbett, Harriet J.

doi:10.1016/j.jpedsurg.2019.10.044

Cited by 20 publications

(19 citation statements)

References 9 publications

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“…These studies were deemed poor quality due to their presentation of outcome measures, which was inconsistent across the patient population assessed (supplementary table 2, https://www.jurology.com). 23,24…”

Section: Resultsmentioning

confidence: 99%

β3-Adrenoceptor Agonist for the Treatment of Bladder Dysfunction in Children: A Systematic Review and Meta-Analysis

et al. 2022

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Purpose:ß3-adrenergic receptor agonists (ß3 agonists) have been used in treatment of overactive bladder (OAB) and neurogenic detrusor overactivity (NDO) in adults. However, their use in children has only recently been approved by the U.S. Food and Drug Administration for patients with NDO. As in adults, the role of ß3 agonists in children may include conditions such as OAB. This systematic review and meta-analysis aims to understand the intended use, efficacy and safety of ß3 agonists in the pediatric population.Materials and Methods:A literature search was performed in February 2021 across MEDLINE®, Embase®, Scopus®, the Cochrane Library and ClinicalTrials.gov. No language restrictions were placed. All records describing the clinical use of ß3 agonists in pediatric patients (<18 years of age) were included, regardless of the methodological design or outcomes assessed. The identified records were screened by 2 independent authors. The reporting was compliant with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Data extraction was performed by 2 independent reviewers, blinded to each other’s extractions. The data were pooled using the fixed effects model.Results:Of 367 records identified, 8 studies were included in the review (3 prospective and 5 retrospective). ß3 agonists led to improvements in both urodynamics parameters and self-reported outcomes such as incontinence. Commonly reported side effects were headaches (3%‒5.9%), constipation (3.5%‒5.7%), rhinitis/nasopharyngitis (1.7%‒5.8%) and blurred vision (1.7%‒2.9%). Clinically meaningful changes in safety outcomes (blood pressure, heart rate, electrocardiogram-related changes, liver function) were rare. Before and after ß3 agonist use, pooled effect estimates for maximum cystometric capacity for 171 patients were mean difference of +98.84 ml (95% CI 74.72, 122.96); for complete dryness, assessment of 235 patients showed a Peto odds ratio of 8.68 (95% CI 5.22, 14.45).Conclusions:ß3 agonists appear to be a promising, effective and safe alternative/adjunctive therapy in management of pediatric NDO or OAB, with improvements in both objective urodynamics parameters and subjective patient-reported outcomes following their use.

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Section: Resultsmentioning

confidence: 99%

β3-Adrenoceptor Agonist for the Treatment of Bladder Dysfunction in Children: A Systematic Review and Meta-Analysis

et al. 2022

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“…In another recent retrospective study, it was reported that mirabegron improved symptoms in about 70% of the children treated for refractory OAB symptoms [20]. Nitti et al [21] showed a statistically significant improvement from baseline to end of study in decreasing the mean number of micturition/day, incontinence, and urgency episodes/day in mirabegron group versus placebo.…”

Section: Discussionmentioning

confidence: 99%

Mirabegron versus Solifenacin in Children with Overactive Bladder: Prospective Randomized Single-Blind Controlled Trial

et al. 2021

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Purpose: The purpose of this study is to investigate the efficacy and safety of mirabegron versus solifenacin in the treatment of newly diagnosed overactive bladder (OAB) in children. Methods: We conducted a prospective randomized controlled study on pediatric patients with newly diagnosed OAB. Patients were randomized into 3 groups: mirabegron (50 mg once daily) in group I, solifenacin (5 mg) in group II, and placebo in group III. Before starting our treatment and at the end of the 3 months course, we obtained a 3-day voiding diary. This diary included incontinence episode per day, mean voided volume per micturition, mean number of micturition per day, and post-void residual urine. Moreover, the parents/patients were asked to rate symptom relief, and the adverse events were recorded throughout the study period. Results: A total of 190 patients aged from 5 to 14 years completed this study. At the end of this trial, both groups I and II showed significant improvement versus placebo regarding our efficacy parameters with no significant difference between group I and II. The overall success rate based on assessment of symptom relief was significantly higher in the treated groups (87.5% in I and 90.2% in II) versus placebo (55.8%). Dry mouth was reported in 2.8, 10, and 0% and constipation in 2.8, 11.4, and 1.4% in group I, II, and III, respectively, without statistically significant difference between group I and placebo. However, there was a significant difference between group II and placebo regarding these side effects. Conclusion: Both mirabegron and solifenacin have comparable efficacy regarding the control of OAB symptoms in the newly diagnosed children, but mirabegrone seems to have less side effects.

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“…Mirabegron works by acting on the smooth muscles of the bladder, causing relaxation which results in the increase in bladder capacity without changing micturition pressure, voiding contraction, and post-void residual (7,9). Mirabegron can be used as monotherapy or in combination with anticholinergics (7,10,11).…”

Section: Introductionmentioning

confidence: 99%

Mirabegron in Overactive Bladder and Its Role in Exit Strategy After Botulinum Toxin Treatment in Children

2022

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PurposeMirabegron is a recent addition to the management options of overactive bladder (OAB) in children. The purpose of this study was to ascertain the role of Mirabegron in the treatment algorithm of therapy-resistant OAB especially after botulinum toxin.MethodsCase notes of all children receiving Mirabegron between July 2017 and February 2020 were reviewed.ResultsForty one children (21 females, 20 males), mean age 12.6 [8–17] years old, commenced Mirabegron: 35 idiopathic OAB, 6 neuropathic OAB. The mean duration of treatment was 20.7 [3–45] months. In total 24 (59%) had Mirabegron after partial/no response to anticholinergics, and 17 (41%) patients had Mirabegron subsequent to botulinum toxin A (BtA) as an exit strategy. In total 35 (85%) patients had combination therapy (Mirabegron and anticholinergics), and 6 (15%) patients had Mirabegron only. Fourteen (34%) had complete response, 17 (41%) had partial response, and 10 (24%) had no response. Side effects were reported in 7 (17%) patients with discontinuation necessitated in 3.ConclusionMirabegron when used alone or in combination with anticholinergics resulted in complete/partial response in 76% of anticholinergic therapy-resistant OAB. In addition to being an important step in treatment escalation after no/partial response to anticholinergics, it has a crucial role in the exit strategy for recurring symptoms after BtA wears off.

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Effectiveness and tolerability of mirabegron in children with overactive bladder: A retrospective pilot study

Cited by 20 publications

References 9 publications

β3-Adrenoceptor Agonist for the Treatment of Bladder Dysfunction in Children: A Systematic Review and Meta-Analysis

β3-Adrenoceptor Agonist for the Treatment of Bladder Dysfunction in Children: A Systematic Review and Meta-Analysis

Mirabegron versus Solifenacin in Children with Overactive Bladder: Prospective Randomized Single-Blind Controlled Trial

Mirabegron in Overactive Bladder and Its Role in Exit Strategy After Botulinum Toxin Treatment in Children

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