Efficacy and safety of vibegron compared with mirabegron for overactive bladder: A systematic review and network meta‐analysis

Abstract

Objectives: The aim of this study was to indirectly compare the efficacy and safety of mirabegron and vibegron in patients with overactive bladder.Methods: A systematic search was performed on Pubmed, Web of Science, Embase, and the Cochrane Central Register of Controlled Trials databases to identify studies from the date of database inception to January 1, 2022. All randomized controlled trials comparing mirabegron or vibegron with tolterodine, imidafenacin, or placebo were eligible. One reviewer extracted data, and a second reviewer checked. Included trials were assessed for similarity, and networks were developed using Stata 16.0 software. Mean differences for continuous variables and odds ratios for dichotomous variables together with their 95% confidence intervals (CIs) were used to rank treatments and compare the differences, respectively.Results: A total of 11 randomized controlled trials and 10 806 patients were included. For each outcome, results for all licensed treatment doses were included.Both vibegron and mirabegron were more efficacious than placebo at reducing the frequency of micturition, incontinence, urgency, urgency incontinence, and nocturia.Vibegron was more efficacious than mirabegron in reducing mean voided volume/ micturition (95% CI [5.15, 14.98]). Safety outcomes for vibegron and mirabegron were similar to those in the placebo group, except for mirabegron, which had a higher risk of nasopharyngitis and cardiovascular adverse events than placebo.Conclusions: Both drugs seem to be comparable and well tolerated, particularly as direct comparisons are not available. However, vibegron may be more effective than mirabegron in reducing mean voided volume.mirabegron, network meta-analysis, overactive bladder, randomized controlled trials, vibegron | INTRODUCTIONOveractive bladder (OAB) is defined as "urgency, with or without urgency incontinence usually accompanied by frequent micturition and nocturia." 1 OAB pathogenesis is diverse, but in most instances, the underlying cause is unclear. OAB is a common health disorder with a worldwide prevalence in adults of 10%-20%, which has gradually increased. 2,3 OAB is a common urological disease, and it seriously affects the quality of life of patients. Current treatments for OAB include behavioral therapy, pharmacological treatment, minimally

A Randomized, Double-Blind, Placebo-Controlled, Bridging Study to Evaluate the Efficacy and Safety of Vibegron in Treating Korean Patients With Overactive Bladder

“…Improvement in daily micturition was similar, but vibegron was associated with significant improvement in total incontinence episodes at week 4 and week 52 as well as voided volume at week 12 and week 52 [21,22]. The most recent systematic review and network meta-analysis concluded that both mirabegron and vibegron were comparable and welltolerated in OAB patients but vibegron might be more effective than mirabegron in improving mean voided volume per micturition [23]. Moreover, despite lack of available real-word data on persistence, vibegron was assumed to be cost-effective from a commercial payor and Medicare perspective when compared with other oral pharmacologic agents for OAB [24].…”