title: Mirabegron for male lower urinary tract symptoms.
abstract: Benign prostatic hyperplasia (BPH) is a common cause of lower urinary tract symptoms (LUTS) in men. Patients with BPH often present with a combination of obstructive and overactive bladder (OAB) symptoms. It is postulated that bladder outlet obstruction (BOO) from BPH results in concomitant OAB symptoms through ischemic induced variations in the response to neurotransmitters of both the detrusor and the urothelium. This altered response leads to the pathologic activation of the micturition reflex, generating sensory dysfunction and involuntary bladder contractions. Alpha-1 adrenoceptor antagonists (alpha-blockers) and 5-alpha reductase inhibitors (5-ARIs) are commonly used to treat the BOO caused by BPH. Anticholinergic agents are frequently used to treat concurrently OAB symptoms caused by the BOO. Unfortunately, anticholinergic medications demonstrate bothersome side effects and a theoretical risk of urinary retention. Basic science and clinical research has led to the development of a new class of pharmaceuticals for the treatment of overactive bladder with diminished risk of urinary retention and lacking many anticholinergic side effects. This novel compound, mirabegron (Mybertriq, Astellas Pharma US, Inc.), is a β₃-adrenoceptor agonist and represents a promising new class of oral agents designed for the treatment of OAB symptoms, with minimal effect on voiding.
authors.affiliation: Departamento de Urología, Hospital Universitario de la Universidad Autónoma de Nuevo León, Av. Madero Y Gonzalitos S/N Mitras Centro, C.P. 64460, Monterrey, Nuevo León, Mexico, osuarezfl@gmail.com.
authors.forename: Oscar
authors.initials: O
authors.lastname: Suarez
authors.forename: David
authors.initials: D
authors.lastname: Osborn
authors.forename: Melissa
authors.initials: M
authors.lastname: Kaufman
authors.forename: W Stuart
authors.initials: WS
authors.lastname: Reynolds
authors.forename: Roger
authors.initials: R
authors.lastname: Dmochowski
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000627:therapeutic use; D000083:Acetanilides / Q000627:therapeutic use*; D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use; D058667:Adrenergic beta-3 Receptor Agonists / Q000627:therapeutic use*; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D053158:Nocturia / Q000188:drug therapy / Q000209:etiology; D011470:Prostatic Hyperplasia / Q000150:complications*; D053448:Prostatism / Q000188:drug therapy / Q000209:etiology; D013844:Thiazoles / Q000627:therapeutic use*; D053201:Urinary Bladder, Overactive / Q000188:drug therapy / Q000209:etiology; D064804:Urological Agents / Q000627:therapeutic use*
chemical_list: D058891:5-alpha Reductase Inhibitors; D000083:Acetanilides; D058668:Adrenergic alpha-1 Receptor Antagonists; D058667:Adrenergic beta-3 Receptor Agonists; D013844:Thiazoles; D064804:Urological Agents; C520025:mirabegron
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