Long‐term persistence with mirabegron in a real‐world clinical setting

Wada, Naoki; Watanabe, Masaki; Banjo, Hiroko; Tsuchida, Miyu; Hori, Junichi; Tamaki, Gaku; Azumi, Makoto; Kita, Masafumi; Κakizaki, Hidehiro

doi:10.1111/iju.13558

Cited by 10 publications

(13 citation statements)

References 23 publications

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“…This result is consistent with that of a previous study that reported that the persistence rates in patients with OAB were better than those in patients with storage symptoms without urinary urgency. 15 The finding in our study, that the baseline urgency symptom was not severe enough (OABSS Q3 ≤ 2) in 30% of the patients, suggests that anticholinergic or ß3-agonist therapies are not used strictly for OAB. Those who took such medications for broader indications, presumably other than OAB, were more likely to abandon treatment earlier.…”

Section: Resultsmentioning

confidence: 60%

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Overactive bladder medication: Persistence, drug switching, and reinitiation

Soda

Tashiro

Koike

et al. 2020

Neurourology and Urodynamics

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Aim: To assess real-world treatment profiles, including the time to and reasons for discontinuation or drug switching, treatment reinitiation, and postdiscontinuation follow-up in patients receiving antimuscarinics or ß3-agonists for overactive bladder (OAB) through a retrospective chart review. Methods: We retrospectively reviewed medical charts of 777 patients, aged ≥18 years, who underwent antimuscarinic or ß3-agonist therapy at our hospital. Data on patient's age, sex, chief complaint, and OAB symptom score at therapy initiation were collected. Treatment persistence was assessed with respect to the median time to discontinuation and the persistence rate at 12 months. Results: Older patients, male patients, and those with more severe urgency symptoms were more likely to show treatment persistence with OAB medications. Treatment persistence with mirabegron was significantly longer than that with antimuscarinics when administered as either the first-or second-line medication. Multivariate analyses showed that urgency severity and use of mirabegron were independently associated with better persistence (p = .026 and p = .018, respectively). Out of 583 patients who discontinued medication, 344 continued with the visit schedule, and the reinitiation rate of the OAB medication was 19% at a median follow-up of 24 months. Conclusion: Although the persistence rates for OAB medications improved with the introduction of mirabegron, most patients still discontinued the medication therapy within 1 year. The treatment strategies for patients with mild symptoms and those who are resistant to medication can still be improved. Tailored individualized treatments that avoid excessive reliance on pharmacotherapy would be key to further improve treatment outcomes in OAB patients.

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Section: Resultsmentioning

confidence: 60%

“…5,13,14 However, most patients discontinued the medication within 1 year. Wada et al 15 reported a 1-year persistence rate >60% for mirabegron using a retrospective chart review. The factors that affect treatment persistence and adherence have been reported to include disease, patient, treatment, and socioeconomic factors.…”

Section: Resultsmentioning

confidence: 99%

Overactive bladder medication: Persistence, drug switching, and reinitiation

Soda

Tashiro

Koike

et al. 2020

Neurourology and Urodynamics

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“…The results of a phase 1 screening survey showed that the most common reasons for discontinuing OAB medication were the medication not working as expected, switching to a new medication, learning to get by without medication, and experiencing side effects 41 . Furthermore, a Japanese single‐center retrospective study found that the biggest reasons for discontinuing mirabegron treatment were unmet treatment expectations, the occurrence of AEs, and symptom improvement 42 . In our study, the proportion of patients who discontinued following no improvement in their symptoms was slightly higher in the mirabegron group, whereas the proportion of patients who discontinued due to side effects was higher in the antimuscarinics group.…”

Section: Discussionmentioning

confidence: 99%

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

Carlson

Nair

Deal³

et al. 2021

LUTS

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Objectives This analysis from the PERSPECTIVE (a Prospective, Non‐interventional Registry Study of Patients Initiating a Course of Drug Therapy for Overactive Bladder) study evaluated treatment persistence with mirabegron or antimuscarinics over a 12‐month period. Methods Participants were adults diagnosed with overactive bladder (OAB) by their health care provider (HCP), who were initiating mirabegron or antimuscarinic treatment. The HCP made all treatment decisions, and patients were followed for 12 months with no mandatory scheduled visits. Information requests were sent to patients at baseline and months 1, 3, 6, and 12. Patients were nonpersistent if they switched, discontinued, or added OAB medications/therapies to their initial treatment. Reasons for discontinuation and switching patterns were investigated. Results Overall, 1514 patients were included (613 mirabegron and 901 antimuscarinic initiators). Persistence rates decreased steadily over time in both groups. A low proportion of patients added or switched medication at each time point. Unadjusted Kaplan‐Meier analysis showed similar persistence rates for both groups. When the data were adjusted for patient characteristics (age, sex, and OAB treatment status), mirabegron initiators had higher persistence rates. No significant differences were noted in unadjusted median time to end of persistence. However, end of treatment persistence by any cause was longer with mirabegron (median: 9.5 vs 6.7 months for antimuscarinics). HCPs stated that the most common reasons for nonpersistence were no symptomatic improvement and side effect aversion. Conclusions Treatment persistence was longer for mirabegron compared with antimuscarinic initiators after controlling for patient characteristics. End of treatment persistence by any cause was also longer with mirabegron.

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“…The persistence of mirabegron monotherapy varies among studies. The reported rate was highest in the study by Martan (71%), followed by Wada (63% and 67% in female and male OAB patients) . These rates are much higher than those reported by Chapple in a UK population (38%) and Kinjo (12.2%) .…”

Section: Discussionmentioning

confidence: 59%

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

Shin

Choo

2019

LUTS

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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.

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Long‐term persistence with mirabegron in a real‐world clinical setting

Abstract: The present study shows a relatively good long-term persistence rate with mirabegron in overactive bladder patients, notwithstanding the retrospective study in an academic hospital. The combined treatment with antimuscarinics could result in a good persistence rate with mirabegron.

Cited by 10 publications

References 23 publications

Overactive bladder medication: Persistence, drug switching, and reinitiation

Overactive bladder medication: Persistence, drug switching, and reinitiation

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

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

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