<p>Mirabegron in the Treatment of Overactive Bladder: Safety and Efficacy in the Very Elderly Patient</p>

Abstract

Lower urinary tract symptoms, including urgency, urgency incontinence, frequency, and nocturia, are highly prevalent in older adults and are associated with significant morbidity and impairment in quality of life. When conservative measures such as bladder training fail to improve symptoms, pharmacological management is recommended by national and international guidelines. Mirabegron, an agonist of the β3 adrenergic receptor, demonstrates similar efficacy to the anticholinergic drugs without the risk of anticholinergic effects, but experience and evidence in the very elderly population are limited. This narrative review examines the current evidence base for mirabegron in very elderly adults.

Side effects of mirabegron studied on ants as models

“…49 A same conclusion follows from an analysis of 5 different trials on adults 65year old and over, which shows that mirabegron compared to placebo is efficient to reduce OAB symptoms and more efficient when add to solifenacin, the adverse effects of this combination being those of each substance, thus no higher than with monotherapy. 50 It is to be noted that combining the usual solifenacin dose (5 mg) with the highest dose of mirabegron (50 mg instead of 25 mg), although superior in efficacy to solifenacin alone, did not demonstrate superior efficacy to mirabegron alone. 45 An experimental study on rats showed that mirabegron plus fesoterodine had a combined effect on the increase of the bladder capacity exceeding the sum of the effects of the two monotherapies.…”

Overactive Bladder Management: Cognitive Risk With Anticholinergics and Alternative Management Options for the General Practitioner

“…For many years the only pharmacologic agent available to treat OAB was anticholinergic drugs, beginning with the use of oxybutynin in the 1970s 15. Anticholinergic receptors are present throughout the entire body.…”

“…For many years the only pharmacologic agent available to treat OAB was anticholinergic drugs, beginning with the use of oxybutynin in the 1970s. 15 Anticholinergic receptors are present throughout the entire body. M1/M2, which are important for higher cognitive function, are present in the brain, and M2/M3 are the primary receptors present in the bladder.…”

A non-interventional cross-sectional re-contact study investigating the relationship between overactive bladder and frailty in older adults in Japan

“…Given the anticipated rise in the older population in both Japan and worldwide [ 29 ], there will likely be an associated increase in the number of patients with OAB, with and without frailty. Further investigation of OAB and its management in the frail older population, including pharmacotherapy, is warranted, therefore [ 29 , 30 , 32 , 33 ]. Recently, a treatment algorithm and guidelines for the management of older frail individuals with urinary incontinence have been developed by the 6th International Consultation on Incontinence [ 34 ].…”