Mirabegron: Pediatric First Approval

Keam, Susan J.

doi:10.1007/s40272-021-00452-4

Cited by 6 publications

(4 citation statements)

References 8 publications

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“…In this perspective, the pharmaceutical armamentarium for β3‐AR agonism is relatively equipped and β3‐AR agonists are also being tested in repurposing trials for cardiovascular and metabolic conditions 8,178,179 . In addition, recently mirabegron, a selective β3‐AR agonist, has been demonstrated safe and well‐tolerated in children 180,181 and even approved for the pediatric population 182 …”

Section: Discussionmentioning

confidence: 99%

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β3‐Adrenoceptor, a novel player in the round‐trip from neonatal diseases to cancer: Suggestive clues from embryo

Filippi

Pini

Cammalleri

et al. 2021

Medicinal Research Reviews

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The role of the β-adrenoceptors (β-ARs) in hypoxia-driven diseases has gained visibility after the demonstration that propranolol promotes the regression of infantile hemangiomas and ameliorates the signs of retinopathy of prematurity (ROP). Besides the role of β2-ARs, preclinical studies in ROP have also revealed that β3-ARs are upregulated by hypoxia and that they are possibly involved in retinal angiogenesis. In a sort of figurative round trip, peculiarities typical of ROP, where hypoxia drives retinal neovascularization, have been then translated to cancer, a disease equally characterized by hypoxia-driven angiogenesis. In this step, investigating the role of β3-ARs has taken advantage of the assumption that cancer growth uses a set of strategies in common with embryo development. The possibility that hypoxic induction of β3-ARs may represent one of the mechanisms through which primarily embryo (and then cancer, as an astute imitator) adapts to grow in an otherwise hostile environment, has grown evidence. In both cancer and embryo, β3-ARs exert

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Section: Discussionmentioning

confidence: 99%

“…8,178,179 In addition, recently mirabegron, a selective β3-AR agonist, has been demonstrated safe and well-tolerated in children 180,181 and even approved for the pediatric population. 182 In this sense, we can at least begin to dream of the next trip.…”

Section: Discussionmentioning

confidence: 99%

β3‐Adrenoceptor, a novel player in the round‐trip from neonatal diseases to cancer: Suggestive clues from embryo

Filippi

Pini

Cammalleri

et al. 2021

Medicinal Research Reviews

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“…25,120 The U.S. Food and Drug Administration has recently approved their use in children with NDO. 121 A recent meta-analysis by Kim et al indicated that ß3 agonists could be considered an effective and safe alternative or adjunctive therapy for pediatric NDO or OAB, improving both objective urodynamic parameters and subjective patient-reported outcomes. 122 ß3 agonists appear to be a promising, effective, and safe alternative/ adjunctive therapy in managing pediatric NDO or OAB.…”

Section: Recommendation 16: Antegrade Continence Enema or Cecostomy T...mentioning

confidence: 99%

2023 Canadian Urological Association/ Pediatric Urologists of Canada guideline: Pediatric patients with neurogenic lower urinary tract dysfunction

Chua,

Yadav,

Wang

et al. 2023

CUAJ

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Prior to Publication, this guideline underwent review by the cua guidelines committee, exPert external reviewers, and the cua executive board. E338 INTRODUCTION AND BACKGROUNDNeurogenic lower urinary tract dysfunction (NLUTD) refers to abnormal function of the bladder, bladder neck, and/or sphincters associated with any neurologic disorder. 1 Congenital pediatric NLUTD is mainly caused by spinal dysraphism, commonly spina bifida (SB). 2 Pediatric NLUTD is increasingly prevalent in Canada. A populationbased study conducted in Canada (excluding Quebec) from 2004-2015 showed that there were 4.4 cases of neural tube defects (NTDs) per 10 000 total births; however, the prevalence of NTDs increased from 3.6 in 2004 to 4.6 per 10 000 in 2015. Specifically, SB was the only NTD subtype with an increasing prevalence over time. 3,4 Pediatric patients with NLUTD are at risk for recurrent urinary tract infections (UTI) and upper tract damage leading to chronic kidney disease, necessitating early detection and management. 2 In addition, advances in prenatal diagnosis of congenital spinal dysraphism in Canada enable early detection and prenatal intervention. 5,6 Managing the resultant pediatric NLUTD requires collaboration among various healthcare providers to ensure healthy long-term outcomes. Purpose and scopeThe Pediatric Urologists of Canada (PUC) and the Canadian Urological Association (CUA) collaborated to provide this guideline of evidence-based recommendations for the diagnosis, management, and treatment of pediatric patients with NLUTD. The target readers of this guideline include pediatric urologists, general urologists, pediatricians, and allied health professionals with the goal of optimizing care and achieving improved subpopulation health outcomes.The definition, terminology, and classification of NLUTD are described in prior CUA clinical practice guidelines on adult patients with NLUTD, 7 which were adapted from the International Continence Society (ICS). 8 For pediatric NLUTD-specific descriptions, we refer readers to the 2016 update report from the standardization committee of the International Children's Continence Society (ICCS). 9 Specifically, for this guideline, the definition for bladder hostility encompasses bladders that are considered high risk for urologic morbidity and is summarized in Table 1, with relevant additional definitions and terminology for pediatric NLUTD. METHODOLOGYThe CUA Guidelines Committee pre-approved the pediatric NLUTD guideline methodology, which uses the ADAPTE approach. The process included a critical appraisal of recent pediatric neurogenic bladder guidelines using AGREE II. 10,11 For the purpose of this guideline formulation, two licensed reference special-

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“…Whether the role of β3-ARs in retinal vascularization would be indisputably proven, then scenarios that currently appear futuristic might open up (Filippi et al, 2021). In particular, it would be possible to evaluate the hypothesis of counteracting the ischemic phase of the disease by intervening on β3-ARs through their selective activation with specific agonists (already available for children) (Keam, 2021). This would eventually prevent retina vessel regression irrespectively on hyperoxia with an efficacy similar to that already observed in preclinical models using PHD inhibitors (Sears et al, 2008;Hoppe et al, 2016), but without the complication of activating a plethora of target genes.…”

Section: New Perspectives To Prevent Rop Occurrencementioning

confidence: 99%

Decoupling Oxygen Tension From Retinal Vascularization as a New Perspective for Management of Retinopathy of Prematurity. New Opportunities From β-adrenoceptors

et al. 2022

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Retinopathy of prematurity (ROP) is an evolutive and potentially blinding eye disease that affects preterm newborns. Unfortunately, until now no conservative therapy of active ROP with proven efficacy is available. Although ROP is a multifactorial disease, premature exposition to oxygen concentrations higher than those intrauterine, represents the initial pathogenetic trigger. The increase of oxygenation in a retina still incompletely vascularized promotes the downregulation of proangiogenic factors and finally the interruption of vascularization (ischemic phase). However, the increasing metabolic requirement of the ischemic retina induces, over the following weeks, a progressive hypoxia that specularly increases the levels of proangiogenic factors finally leading to proliferative retinopathy (proliferative phase). Considering non-modifiable the coupling between oxygen levels and vascularization, so far, neonatologists and ophthalmologists have “played defense”, meticulously searching the minimum necessary concentration of oxygen for individual newborns, refining their diagnostic ability, adopting a careful monitoring policy, ready to decisively intervene only in a very advanced stage of disease progression. However, recent advances have demonstrated the possibility to pharmacologically modulate the relationship between oxygen and vascularization, opening thus the perspective for new therapeutic or preventive opportunities. The perspective of a shift from a defensive towards an attack strategy is now at hand.

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Mirabegron: Pediatric First Approval

Cited by 6 publications

References 8 publications

β3‐Adrenoceptor, a novel player in the round‐trip from neonatal diseases to cancer: Suggestive clues from embryo

β3‐Adrenoceptor, a novel player in the round‐trip from neonatal diseases to cancer: Suggestive clues from embryo

2023 Canadian Urological Association/ Pediatric Urologists of Canada guideline: Pediatric patients with neurogenic lower urinary tract dysfunction

Decoupling Oxygen Tension From Retinal Vascularization as a New Perspective for Management of Retinopathy of Prematurity. New Opportunities From β-adrenoceptors

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