Add-on therapy effective for overactive bladder

  • Int J Urol
  • 13 Dec 2018

  • curated by Craig Hicks
  • Clinical Essentials
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Takeaway

  • Antimuscarinic add‐on therapy is well-tolerated and effective in patients initially treated with mirabegron (Myrbetriq) for overactive bladder symptoms.

Why this matters

  • “Poor responders to initial treatment might achieve an improved outcome if they subsequently receive [mirabegron] and an antimuscarinic in combination,” say researchers.

Study design

  • Researchers studied patients with overactive bladder symptoms who had been treated with mirabegron 50 mg once daily for at least 6 weeks (n=647; mean age, 65 years; 88.1% women).
  • They randomly assigned these patients to treatment groups, each receiving mirabegron 50 mg/day plus 1 of 4 antimuscarinics:
    • solifenacin (VESIcare) 5 mg
    • propiverine (Mictoryl) 20 mg
    • imidafenacin (Uritos) 0.2 mg
    • tolterodine (Detrol) 4 mg
  • Funding: Astellas Pharma Inc.

Key results

  • 80.2% of patients experienced ≥1 treatment‐emergent adverse event, such as dry mouth, nasopharyngitis, and constipation, with similar event rates in all treatment groups.
  • Researchers observed significant improvements in overactive bladder symptom scores and parameters calculated from patient micturition diaries, such as micturitions, urgency episodes, urinary incontinence episodes, urgency urinary incontinence episodes, mean voided volume, and nighttime micturitions.

Limitations

  • The trial was open-label and had no placebo or monotherapy arms.

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