title: Use of mirabegron in treating overactive bladder.
abstract: The lack of an alternative to antimuscarinics has led to the search for new drug targets for overactive bladder (OAB) symptoms. The presence of β-3 adrenoreceptors in the bladder has been confirmed, and they are known to have a role in bladder relaxation. Targeting these receptors improves bladder compliance on filling and increases bladder capacity. MEDLINE literature search on efficacy and safety of mirabegron was performed. The US Food and Drug Administration Web site, clinicaltrials.gov, and controlled-trials.com online trial registries were searched for English-language articles containing the term "mirabegron". Finally, abstracts from recent International scientific meetings were searched for randomised controlled trials (RCTs). Studies show that mirabegron reduces the number of micturitions and incontinence episodes in a 24-h period compared with placebo. Dry mouth and gastrointestinal disturbances are the most common side effects, but these have been rated as mild to moderate. A small rise in mean heart rate and blood pressure has been shown. Further investigations are ongoing and results are awaited. Although mirabegron is metabolised by CYP2D6, it is also thought to inhibit the activity of this enzyme. Therefore, potential drug interactions with other CYP2D6 substrates need to be further studied. Mirabegron is a promising alternative to antimuscarinics. Further information on its long-term use in terms of efficacy, safety, and tolerability is awaited.
authors.affiliation: Department of Urogynaecology, St. Mary's Hospital, Cambridge Wing, Praed Street, W1 1NY London, UK.
authors.forename: Alka A
authors.initials: AA
authors.lastname: Bhide
authors.forename: G Alessandro
authors.initials: GA
authors.lastname: Digesu
authors.forename: Ruwan
authors.initials: R
authors.lastname: Fernando
authors.forename: Vik
authors.initials: V
authors.lastname: Khullar
mesh_terms: D000083:Acetanilides / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000318:Adrenergic beta-Agonists / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004347:Drug Interactions; D005260:Female; D006801:Humans; D008297:Male; D013844:Thiazoles / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*
chemical_list: D000083:Acetanilides; D000318:Adrenergic beta-Agonists; D013844:Thiazoles; C520025:mirabegron