Higher urge severity score predicts resumption of overactive bladder (OAB) medication following discontinuation of mirabegron treatment in patients with OAB

Abstract

Objectives: This study investigated factors predicting the resumption of mirabegron following its discontinuation with successful treatment of overactive bladder (OAB).Methods: In all, 374 OAB patients reporting an improvement in subjective symptoms after a minimum of 3 months treatment with mirabegron 25 mg, q.d., were screened. Those wanting to continue with the medication (n = 109) were excluded from the study. The remaining 265 patients discontinued mirabegron and their outcomes were evaluated at baseline (discontinuation) and 1, 3, 6, 9, and 12 months using the International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS), Urgency Severity Scale (USS), Patient's Perception of Bladder Condition (PPBC), and Global Response Assessment (GRA), as well as uroflowmetry and post-void residual (PVR).Results: After mirabegron discontinuation, 203 patients completed follow-up. The mean (AESD) duration from discontinuing medication to resumption of mirabegron was 2.25 AE 1.17 months (range 1-12 months). Compared with the 111 (54.7%) patients who did not resume mirabegron, the 92 (45.3%) patients who resumed mirabegron had a higher USS at time of discontinuation (1.18 ± 1.76 vs. 0.65 ± 1.33; P = 0.017). The USS was a strong predictor of mirabegron resumption (P = 0.02; odds ratio 1.315; 95% confidence interval 1.051-1.646).Conclusions: Among OAB patients who were successfully treated with mirabegron for ≥3 months, nearly half requested resumption of mirabegron after discontinuation. A higher USS was found to predict retreatment after discontinuation of mirabegron in OAB patients. K E Y W O R D Sdiscontinuation, mirabegron, overactive bladder

Comparative study of different combinations of mirabegron and antimuscarinics in treatment for overactive bladder syndrome in elderly patients

“…Previous studies have shown that patients who were successfully treated with mirabegron for ≥ 3 months, nearly half requested the resumption of mirabegron after discontinuation. There is no wonder why 47.6% of patients in group 4 preferred to resume M25 after treatment with M25 + S5 in this study [ 25 ].…”

Individualizing medical treatment of overactive bladder

“…In one recent clinical trial, mirabegron treatment was discontinued in OAB patients with symptom improvement after 3-month medication [ 39 ]. Among 682 patients treated with mirabegron for 3 months, 321 (47.1%) did not come back, 109 (16.0%) continue mirabegron treatment due to symptom persist, and 252 (36.9%) discontinued medication and return for follow-up visit.…”

Continuous administration of mirabegron has advantages in inhibition of central sensitization compared with short‐term treatment cessation in a mouse model of overactive bladder

“…Kim et al 2 and Lee et al 3 reported 52%–62% OAB recurrence rates in the patients who discontinued antimuscarinics after successful results. Wang et al 4 reported that 109 (16%) patients continued mirabegron treatment, and 252 (36.9%) patients, who discontinued the treatment, came back for re‐treatment among a total of 682 patients, indicating that 53% of patients in total have not stopped the drug management. However, this study reported the results during an observation period of 3 months; therefore, they could find more relapsed cases if they followed up for a longer term.…”