Premium
Effectiveness and persistence of mirabegron as a first‐line treatment in patients with overactive bladder in real‐life practice
Author(s) -
Shin Jung Hyun,
Choo MyungSoo
Publication year - 2019
Publication title -
luts: lower urinary tract symptoms
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.451
H-Index - 15
eISSN - 1757-5672
pISSN - 1757-5664
DOI - 10.1111/luts.12253
Subject(s) - mirabegron , medicine , overactive bladder , nocturia , urology , urinary urgency , urinary system , alternative medicine , pathology
Objectives To evaluate the effectiveness and persistence of mirabegron as a first‐line treatment in patients with overactive bladder (OAB) in real‐life practice. Methods We retrospectively analyzed patients with OAB who received mirabegron (50 mg) as a first‐line treatment. According to treatment course, patients were divided into three groups, (a) mirabegron only (monotherapy group), (b) mirabegron and anticholinergics (add‐on group), and (c) mirabegron replaced with another treatment (switch group). The patients' symptoms were documented with a voiding diary including an urgency scale and a patient perception of treatment benefit questionnaire (PPTB). Follow‐up was at 4 weeks after initial treatment and then 2 months later, according to our routine protocol. Results A total of 196 patients were included: 128 patients (65.3%) received monotherapy and 60 patients (30.6%) received add‐on therapy. Eight patients discontinued mirabegron and switched to another treatment modality. The add‐on group had more episodes of baseline urinary frequency, nocturia and urgency than the monotherapy group ( P = 0.011, 0.001, and 0.006, respectively). In the monotherapy group, mean daily frequency, nocturia, urgency episodes, and urgency urinary incontinence were improved ( P < 0.05) after mirabegron treatment. The persistence of mirabegron monotherapy was 68.0% at 3 months, 54.4% at 6 months, and 39.4% at 12 months. Treatment‐naïve patients had better persistency than previously anticholinergics‐treated patients. Conclusions Mirabegron is an effective first‐line therapy for OAB, but has a persistence rate of 39.4% at 12 months. Patients with severe baseline OAB symptoms tended to require add‐on therapy during follow‐up.