Literature DB >> 25030325

Third-line treatment for overactive bladder: should mirabegron be tried before intravesical botulinum toxin A therapy?

Aswini Balachandran1, Natasha Curtiss, Maya Basu, Jonathan Duckett.   

Abstract

INTRODUCTION AND HYPOTHESIS: Mirabegron is a new beta 3 agonist for the treatment of overactive bladder (OAB). Although there are extensive data from randomised controlled trials, there is little real world evidence about its effectiveness and side effects. We conducted a prospective cohort study to evaluate the effectiveness of mirabegron as third-line treatment in patients with refractory OAB who did not benefit from antimuscarinic therapy and bladder drill.
METHODS: The study was a prospective consecutive cohort of 67 women treated with mirabegron 50 mg. All the patients had symptoms of urgency with or without urgency incontinence and had failed to improve with bladder drill and at least one antimuscarinic medication. The outcomes were assessed after 6 weeks using the International Consultation of Incontinence Modular Questionnaire Short Form (ICIQ-SF), Patient Global Impression of Improvement (PGI-I) scale and Kings Health Questionnaire (KHQ).
RESULTS: The mean number of previous antimuscarinics was 2.81 (range 1-6). Forty out of 67 patients (60 %) described an improvement in their OAB. Responders demonstrated a significant improvement in 5 out of 10 domains of the KHQ. Similarly, the ICI-Q score improved from a mean of 12.7 (±5.3) to 9.2 (±5.3; p ≤ 0.008). Seven women (10 %) stopped mirabegron because of side effects.
CONCLUSIONS: This post-marketing surveillance study confirms that mirabegron improves clinical and quality of life outcomes in patients with OAB. The rate of side effects was low. This study supports mirabegron use as a third-line treatment for overactive bladder.

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Year:  2014        PMID: 25030325     DOI: 10.1007/s00192-014-2462-2

Source DB:  PubMed          Journal:  Int Urogynecol J        ISSN: 0937-3462            Impact factor:   2.894


  15 in total

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Review 2.  Mirabegron in overactive bladder: a review of efficacy, safety, and tolerability.

Authors:  Christopher R Chapple; Linda Cardozo; Victor W Nitti; Emad Siddiqui; Martin C Michel
Journal:  Neurourol Urodyn       Date:  2013-10-11       Impact factor: 2.696

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Journal:  Eur Urol       Date:  2010-04-23       Impact factor: 20.096

4.  Repeated botulinum toxin type A injections for refractory overactive bladder: medium-term outcomes, safety profile, and discontinuation rates.

Authors:  Christopher Dowson; Jane Watkins; Mohammad S Khan; Prokar Dasgupta; Arun Sahai
Journal:  Eur Urol       Date:  2011-12-13       Impact factor: 20.096

5.  A proof-of-concept study: mirabegron, a new therapy for overactive bladder.

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Journal:  Neurourol Urodyn       Date:  2013-02-19       Impact factor: 2.696

6.  OnabotulinumtoxinA for the treatment of patients with overactive bladder and urinary incontinence: results of a phase 3, randomized, placebo controlled trial.

Authors:  Victor W Nitti; Roger Dmochowski; Sender Herschorn; Peter Sand; Catherine Thompson; Christopher Nardo; Xiaohong Yan; Cornelia Haag-Molkenteller
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7.  Results of a randomized phase III trial of mirabegron in patients with overactive bladder.

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Review 8.  The effects of antimuscarinic treatments in overactive bladder: an update of a systematic review and meta-analysis.

Authors:  Christopher R Chapple; Vik Khullar; Zahava Gabriel; Dominic Muston; Caty Ebel Bitoun; David Weinstein
Journal:  Eur Urol       Date:  2008-06-20       Impact factor: 20.096

9.  New developments in the management of overactive bladder: focus on mirabegron and onabotulinumtoxinA.

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10.  Health economics perspective of fesoterodine, tolterodine or solifenacin as first-time therapy for overactive bladder syndrome in the primary care setting in Spain.

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Journal:  BMC Urol       Date:  2013-10-21       Impact factor: 2.264

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  3 in total

1.  Metastatic breast cancer presenting as detrusor overactivity.

Authors:  Aswini Aparna Balachandran; Jonathan Duckett
Journal:  BMJ Case Rep       Date:  2014-12-22

2.  King's Health Questionnaire to assess subjective outcomes after surgical treatment for urinary incontinence: can it be useful?

Authors:  Rita Luz; Inês Pereira; Alexandra Henriques; Ana Luísa Ribeirinho; Alexandre Valentim-Lourenço
Journal:  Int Urogynecol J       Date:  2016-07-16       Impact factor: 2.894

Review 3.  Refractory overactive bladder: a common problem?

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Journal:  Int Urogynecol J       Date:  2015-03-20       Impact factor: 2.894

  3 in total

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