Thursday, October 31, 2013

Efficacy of Mirabegron in Patients With and Without Prior Antimuscarinic Therapy for Overactive Bladder

Mirabegron provided numerical improvements in incontinence and micturition frequency in treatment-naïve patients and in patients who had received prior antimuscarinic therapy and discontinued due to insufficient efficacy or poor tolerability. In prior antimuscarinic users who discontinued due to insufficient efficacy, mirabegron showed numerical improvements in both outcomes whereas re-treatment with the antimuscarinic, tolterodine, produced an effect size similar to placebo. The efficacy and tolerability profile of mirabegron suggest that it may represent a valuable therapeutic option for patients with OAB who experience insufficient benefit from antimuscarinic therapy and in those who are intolerant of the associated AEs (e.g., dry mouth, constipation). In patients who received mirabegron in the overall trial, dry mouth, the most common[6,7]and bothersome side effect of antimuscarinic agents,[8]occurred with a similar incidence as with placebo (2.6–2.8%) and a three-fold lower incidence than in patients receiving tolterodine ER 4 mg (10.1%). This post hoc analysis provides valuable insights but confirmation of its results will be required in randomized prospective trials of OAB patients with and without prior antimuscarinic therapy.



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