Persistence and adherence with mirabegron vs antimuscarinics in overactive bladder: Retrospective analysis of a UK General Practice prescription database

Wagg, Adrian; Foley, Steve; Peters, John; Nazir, Jameel; Kool-Houweling, Leanne; Scrine, Ludmila

doi:10.1111/ijcp.12996

Cited by 33 publications

(49 citation statements)

References 24 publications

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“…In this situation, and/or if unacceptable adverse events occur, AUA guidelines recommend dose modification or a trial with another antimuscarinic, or a β3‐adrenoreceptor agonist such as mirabegron . Recent studies have shown increased persistence rates with mirabegron vs antimuscarinics in the UK, Canada, and Japan, suggesting an improved efficacy/tolerability balance for mirabegron vs antimuscarinics …”

Section: Discussionmentioning

confidence: 99%

“…19 Recent studies have shown increased persistence rates with mirabegron vs antimuscarinics in the UK, Canada, and Japan, suggesting an improved efficacy/ tolerability balance for mirabegron vs antimuscarinics. [22][23][24] It is recognized that treatment for LUTS has a high rate of discontinuation. 22,25,26 Among men, feeling of incomplete emptying (with or without bother) was associated with a higher chance of treatment discontinuation, while hesitancy and bother with post-micturition dribble were associated with a lower chance.…”

Section: Discussionmentioning

confidence: 99%

“…[22][23][24] It is recognized that treatment for LUTS has a high rate of discontinuation. 22,25,26 Among men, feeling of incomplete emptying (with or without bother) was associated with a higher chance of treatment discontinuation, while hesitancy and bother with post-micturition dribble were associated with a lower chance. Among women, bother with the leak for no reason and with nocturnal enuresis were associated with a higher chance of discontinuation.…”

Section: Discussionmentioning

confidence: 99%

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Impact of LUTS on treatment‐related behaviors and quality of life: A population‐based study in Brazil

Soler¹,

Averbeck

Koyama³

et al. 2019

Neurourology and Urodynamics

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AimsTo report on the impact of lower urinary tract symptoms (LUTS) on treatment‐related behaviors and quality of life in Brazilian adults greater than or equal to 40 years.MethodsData were from a computer‐assisted telephone survey conducted in Brazil between 1 September and 31 December 2015 (Brazil LUTS study). Participants were adults greater than or equal to 40 years with landlines living in major cities from five geographical regions in Brazil. Participants rated how often they experienced individual LUTS during the previous month and associated bother, and the impact on quality of life (QoL), treatment seeking, treatment, treatment satisfaction, and treatment discontinuation. Multiple logistic regression models were adjusted to analyze the simultaneous effects of predictor variables on each dependent variable.ResultsWhen the presence of LUTS was defined as symptoms occurring less than half the time or more, one‐quarter of respondents sought treatment but 6% fewer actually received treatment. Of these, around 25% reported dissatisfaction with treatment and almost 10% reported treatment discontinuation. The occurrence of some symptoms and, in particular, the resultant bother were significantly related to worse QoL and to treatment‐related outcomes, such as treatment seeking, actual treatment, treatment dissatisfaction, and treatment discontinuation. Symptoms of all three categories were associated with all these domains for both sexes.ConclusionsThis is the first population‐based study carried out in South America showing that treatment seeking and treatment rates for LUTS are low. Since the LUTS prevalence is high, this reinforces the importance of a comprehensive medical assessment, focusing on the resulting bother, for more appropriate and personalized patient management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Impact of LUTS on treatment‐related behaviors and quality of life: A population‐based study in Brazil

Soler¹,

Averbeck

Koyama³

et al. 2019

Neurourology and Urodynamics

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“…It seems that a greater persistence is obtained in those of retrospective design compared with the prospective ones (with patient follow-up), with the exception of a prospective case series of 354 patients, which showed a persistence of 25% at 12 months. 32 This current study's treatment review, based on safety and efficacy criteria, achieved a reduction in the IG leading to potential saving, as calculated from the official expenditure data provided by the public insurer (CatSalut). In the literature there are studies that evaluate the economic cost of OAB, although methodological differences do not allow comparisons, and the authors believe that caution should be employed in the generalisation of results.…”

Section: Intervention Groupmentioning

confidence: 96%

Effectiveness of an intervention to optimise the use of mirabegron for overactive bladder: a quasi-experimental study in primary care

et al. 2018

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BackgroundOveractive bladder is a composite of lower urinary tract storage symptoms. Pharmacological treatment is widely employed despite markedly modest efficacy data, adverse effects, and costs for the health system.AimTo determine the 12-month efficacy of an intervention delivered by GPs on mirabegron revision and, if appropriate, discontinuation of treatment.Design and settingMulticentre, quasi-experimental study in Barcelona (Catalonia), Spain.MethodTwo groups composed of 17 intervention and 34 control practices were formed. The follow-up period was 12 months, from 1 January to 31 December 2017. A structured intervention was designed consisting of initiatives with GPs and urology/gynaecology specialists. The primary outcome was mirabegron use at 12 months.ResultsOf the 1932 patients, a significant discontinuation in treatment was observed at 12 months’ follow-up in the intervention group (IG) (n = 433 out of 762, 56.8%), in contrast with the control one (CG) (n = 484 out of 1170, 41.4%) (P<0.001). There was also a reduced incorporation of new treatments in the IG (n = 214 out of 762, 28.1%) compared with the CG (n = 595 out of 1170, 50.9%) (P<0.001). In relation to patients with treatment at the beginning and end of the period, there was a decrease of 219 (28.7%) patients in the IG and an increase of 111 (9.5%) in the CG (P<0.001).ConclusionThe structured intervention showed optimisation in the use of mirabegron. When considering discontinuation it is necessary to provide clear data on the benefits and/or risks for patients and their caregivers, as such information is a precondition for shared decision making.

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“…Conversely, mirabegron is a first-in-class selective oral β 3 -adrenoceptor agonist, and therefore does not contribute to ACB. Mirabegron has demonstrated similar efficacy as antimuscarinics but with improved tolerability in men and women ≥18 years of age with symptoms of OAB for ≥ 3 months [24][25][26] and, consequently, better persistence [27].…”

Section: Introductionmentioning

confidence: 99%

Cost Effectiveness of Mirabegron Compared with Antimuscarinic Agents for the Treatment of Adults with Overactive Bladder in Colombia

Parisé¹,

Espinosa²,

Dea³

et al. 2019

PharmacoEconomics Open

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Objectives The aim of this study was to evaluate the cost effectiveness of mirabegron relative to two antimuscarinics, oxybutynin extended release (ER) and tolterodine ER, in patients with overactive bladder (OAB) from the perspective of a third-party payer in Colombia. Methods A Markov model simulated the therapeutic management, disease course, and complications in hypothetical cohorts of OAB patients over a 5-year period. The model predicted costs and three outcomes: quality-adjusted life-years (QALYs), micturition state improvement (MSI), and incontinence state improvement (ISI). In each 1-month cycle, patients could transition between different health states reflecting symptom severity. Transition probabilities were estimated from a published mirabegron trial and mixed treatment comparison. Other inputs such as treatment discontinuation based on treatment-specific rates of persistence, resource use and costs, anticholinergic burden, comorbidity treatment, and drug acquisition were obtained from Società Italiana Scienze Mediche, Instituto de Seguros Sociales Tariff Manual, published literature, and expert opinion. Deterministic and probabilistic sensitivity analyses were conducted. Costs are presented in 2017 Colombia Pesos (COP). Results Mirabegron was cost effective for all outcome measures at a willingness-to-pay threshold of 124,919,725 COP, which is three times the per capita gross domestic product (GDP). Using QALYs as the measure of effect, mirabegron had an incremental cost-effectiveness ratio (ICER) of 85,802,036 COP/QALY (26,365 USD/QALY) and 66,360,134 COP/ QALY (20,384 USD/QALY) versus oxybutynin and tolterodine, respectively. Probabilistic sensitivity analyses showed that mirabegron was cost effective in 99.5% and 100% of simulations compared with oxybutynin and tolterodine, respectively. Using MSI and ISI as the measure of effects yielded ICERs below one GDP. Conclusions Mirabegron is a cost effective alternative to oxybutynin and tolterodine from the perspective of a third-party payer in Colombia.

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Persistence and adherence with mirabegron vs antimuscarinics in overactive bladder: Retrospective analysis of a UK General Practice prescription database

Cited by 33 publications

References 24 publications

Impact of LUTS on treatment‐related behaviors and quality of life: A population‐based study in Brazil

Impact of LUTS on treatment‐related behaviors and quality of life: A population‐based study in Brazil

Effectiveness of an intervention to optimise the use of mirabegron for overactive bladder: a quasi-experimental study in primary care

Cost Effectiveness of Mirabegron Compared with Antimuscarinic Agents for the Treatment of Adults with Overactive Bladder in Colombia

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