title: New developments in the management of overactive bladder: focus on mirabegron and onabotulinumtoxinA.
abstract: In the last few years, much new information has been generated on the pathophysiology, possible therapeutic targets, and pharmacologic treatment of overactive bladder (OAB). Antimuscarinic drugs are still first-line pharmacologic treatment for OAB and often have good initial response rates, but adverse effects and decreasing efficacy cause long-term compliance problems, prompting a search for new therapeutic alternatives. Mirabegron and onabotulinumtoxinA, two drugs with different mechanisms of action, and with adverse effect profiles different from those of antimuscarinics, were recently approved for treatment of OAB. However, their place in the treatment of this disorder has not yet been established. In this short review, the mechanisms of action, clinical efficacy, and safety profiles of these drugs are discussed and compared with those of the current gold standard, antimuscarinic agents.
authors: Institute of Regenerative Medicine, Wake Forest University School of Medicine, and Department of Urology, Wake Forest Baptist Medical Center, Winston Salem, NC, USA.
authors: Karl-Erik
authors: KE
authors: Andersson
keywords: antimuscarinics; mirabegron; onabotulinumtoxinA
references: Eur Urol. 2008 Sep;54(3):543-62
references: 18599186
references: Eur Urol. 2012 Dec;62(6):1130-42
references: 22985745
references: Urol Int. 2012;89(1):1-8
references: 22738896
references: J Urol. 2010 Apr;183(4):1288-95
references: 20171668
references: Xenobiotica. 2012 Dec;42(12):1187-96
references: 22834478
references: Drug Metab Dispos. 2012 Apr;40(4):815-24
references: 22269146
references: Clin Pharmacol Ther. 2012 Dec;92(6):696-706
references: 23149929
references: Handb Exp Pharmacol. 2011;(202):319-44
references: 21290234
references: Eur Urol. 2008 Oct;54(4):740-63
references: 18632201
references: Eur Urol. 2012 Dec;62(6):1165-73
references: 22981677
references: J Urol. 2012 Nov;188(5):1993-9
references: 22999538
references: Neurourol Urodyn. 2007 Oct;26(6 Suppl):934-47
references: 17696154
references: J Urol. 2010 Mar;183(3):1077-81
references: 20092838
references: Eur J Pharmacol. 2013 Jan 15;699(1-3):101-5
references: 23246623
references: J Urol. 2013 Apr;189(4):1388-95
references: 23079373
references: Eur Urol. 2011 Mar;59(3):377-86
references: 21168951
references: BJU Int. 2008 Feb;101(3):366-70
references: 18184328
references: J Urol. 2010 Dec;184(6):2578-85
references: 21030043
references: Eur Urol. 2011 Oct;60(4):784-95
references: 21782318
references: Int J Clin Pract. 2011 Sep;65(9):997-1004
references: 21849011
references: Neurochem Int. 2008 May;52(6):1068-75
references: 18187233
references: BJU Int. 2006 Dec;98(6):1310-4
references: 17026593
references: Eur J Clin Pharmacol. 2012 Jan;68(1):97-9
references: 21710237
references: Xenobiotica. 2012 Oct;42(10):957-67
references: 22509825
references: J Pharmacol Exp Ther. 2007 May;321(2):642-7
references: 17293563
references: Naunyn Schmiedebergs Arch Pharmacol. 2013 Jan;386(1):71-8
references: 23224420
references: J Urol. 2013 Jun;189(6):2186-93
references: 23246476
references: J Urol. 2012 Dec;188(6 Suppl):2455-63
references: 23098785
references: J Urol. 2005 Sep;174(3):977-82; discussion 982-3
references: 16094018
references: BJU Int. 2008 Sep;102(7):774-9
references: 18616691
references: Eur Urol. 2012 Jun;61(6):1178-84
references: 22306320
references: BJU Int. 2007 Nov;100(5):987-1006
references: 17922784
references: BMJ. 2003 Apr 19;326(7394):841-4
references: 12702614
references: J Urol. 2006 Mar;175(3 Pt 1):1138-42
references: 16469640
references: Eur Urol. 2009 Nov;56(5):810-9
references: 19683859
references: Cochrane Database Syst Rev. 2012 Jan 18;1:CD005429
references: 22258963
references: Int J Clin Pharmacol Ther. 2012 Nov;50(11):838-50
references: 22943933
references: J Urol. 2007 Jun;177(6):2231-6
references: 17509328
references: Neurourol Urodyn. 2010 Jun;29(5):771-6
references: 19816919
references: Int J Urol. 2013 Jan;20(1):21-7
references: 23072271
references: Neurotoxicology. 2005 Oct;26(5):785-93
references: 16002144
references: J Urol. 2008 Jul;180(1):217-22
references: 18499184
references: Eur Urol. 2013 Feb;63(2):283-95
references: 23182126
references: Eur Urol. 2012 Dec;62(6):1157-64
references: 22480459
references: Eur Urol. 2012 Nov;62(5):834-40
references: 22695239
references: Nat Clin Pract Urol. 2008 Jun;5(6):319-28
references: 18461049
references: J Physiol. 1955 Jun 28;128(3):593-607
references: 13243351
references: Curr Opin Urol. 2009 Jul;19(4):380-94
references: 19448545
references: Int Urol Nephrol. 2012 Feb;44(1):91-7
references: 21643644
references: Urology. 2012 Mar;79(3):744.e1-7
references: 22197203
references: Clin Ther. 2012 Oct;34(10):2144-60
references: 23063375
references: Biochimie. 2000 May;82(5):427-46
references: 10865130
references: J Cell Sci. 2007 Aug 15;120(Pt 16):2864-74
references: 17666428
references: Naunyn Schmiedebergs Arch Pharmacol. 2013 Mar;386(3):177-83
references: 23263450
references: Br J Clin Pharmacol. 2011 Aug;72(2):186-96
references: 21595741
references: Neurourol Urodyn. 2011 Apr;30(4):556-62
references: 21351127
references: Eur Urol. 2013 Feb;63(2):296-305
references: 23195283
references: BJU Int. 2012 Jul;110(2 Pt 2):E132-42
references: 22734512
references: Neurochem Int. 2004 Dec;45(7):987-93
references: 15337297
references: BJU Int. 2012 Dec;110(11):1767-74
references: 22409769
references: J Urol. 2010 Dec;184(6):2416-22
references: 20952013
references: PLoS One. 2011 Feb 23;6(2):e16718
references: 21373193
references: BJU Int. 2007 Nov;100(5):1007-14
references: 17922785
references: Naunyn Schmiedebergs Arch Pharmacol. 2013 Mar;386(3):247-53
references: 23239087
references: Eur Urol. 2012 Sep;62(3):507-14
references: 22236796