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

Abstract

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.

Efficacy and safety of desmopressin orally disintegrating tablets 25 and 50 μg in male patients with nocturia: A Japanese real‐world multicenter clinical study

“…At 48 weeks, it was 40.3%, which was similar to those of other medications against storage symptoms; for example, 35% to 68% for antimuscarinics. On the other hand, the persistence rate at 12 weeks was 51.3% in this study, which was lower than for other drugs; for example, 58% to 80% for antimuscarinics 13,14 . Thus, although about half of the patients discontinued desmopressin treatment immediately after administration, the remaining patients continued it for a long time.…”

“…On the other hand, the persistence rate at 12 weeks was 51.3% in this study, which was lower than for other drugs; for example, 58% to 80% for antimuscarinics. 13,14 Thus, although about half of the patients discontinued desmopressin treatment immediately after administration, the remaining patients continued it for a long time. Immediate discontinuation may be due to severe adverse events such as hyponatremia, which is different from other medications for LUTS.…”

Clinical Utility of β3-Adrenoreceptor Agonists for the Treatment of Overactive Bladder: A Review of the Evidence and Current Recommendations

“…In addition, data showing that female patients have better adherence to mirabegron treatment than men may implicate lower efficacy in men than women. 31 This is consistent with previous findings demonstrating that male patients suffering from OAB symptoms generally have a lower response rate when treated using AChs than women. This probably reflects the fact that the etiology of male LUTSs is more complex, as it may include additional factors, such as bladder-outflow obstruction, resulting in urothelial dysfunction, chronic bladder ischemia, and inflammation.…”

Mirabegron in the Management of Overactive Bladder Syndrome

“…However, once adjusted for age, sex and prior OAB medication use, persistence was higher for mirabegron. 72 …”

“…However, once adjusted for age, sex and prior OAB medication use, persistence was higher for mirabegron. 72 In a prospective case series, long-term persistence with mirabegron was investigated in 354 women who received mirabegron. A quarter of all patients (90/354) continued to receive mirabegron at 1 year.…”