title: The Current Indications and the Benefits of Combining a β3-Agonist with an Anticholinergic for the Treatment of OAB.
abstract: Combination therapy with anti-muscarinics (AMs) and β3 agonists (β3As) has recently been proposed as a possible treatment for the management of patients with Overactive Bladder (OAB).
  
  
  METHODS
  A National Center for Biotechnology Information PubMed search for relevant articles published between 2007 and 2014 was performed by combining the following Patient population, Intervention, Comparison, Outcome (PICO) terms: overactive bladder, antimuscarinics, β3 agonists, combination therapy, efficacy, tolerability and outcomes. Additional references were obtained from the reference list of full-text manuscripts. Abstracts presented at the annual congresses of the European Association of Urology, American Urology Association and the International Continence Society were included.
  
  
  RESULTS
  The combination therapy, in the management of OAB symptoms, has recently been investigated in animal models and in a phase II randomized clinical trial. Compared with AMs monotherapy, combination treatment improved mean voided volume per micturition, micturition frequency and reduced urgency episodes. No dose related trends in adverse events (AEs) were observed between combination group and monotherapy group. Incidence of constipation was slightly increased in combination therapy group.
  
  
  CONCLUSIONS
  Combination therapy seems to be an effective and safe treatment in the management of OAB. However, further cost-effectiveness studies are needed to evaluate the definitive role of this approach for the management of patients with OAB.
authors.affiliation: Ospedale Sant'Andrea, University "La Sapienza", Roma, Italy. cosimodenunzio@virgilio.it.
authors.forename: Cosimo
authors.initials: C
authors.lastname: De Nunzio
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Presicce
authors.forename: Luisella
authors.initials: L
authors.lastname: Pirozzi
authors.forename: Pietro
authors.initials: P
authors.lastname: Castellan
authors.forename: Luigi
authors.initials: L
authors.lastname: Schips
authors.forename: Luca
authors.initials: L
authors.lastname: Cindolo
authors.forename: Riccardo
authors.initials: R
authors.lastname: Lombardo
authors.forename: Andrea
authors.initials: A
authors.lastname: Tubaro
mesh_terms: D058667:Adrenergic beta-3 Receptor Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D018680:Cholinergic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D018727:Muscarinic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D022702:Receptors, Adrenergic, beta-3; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*
chemical_list: D058667:Adrenergic beta-3 Receptor Agonists; D018680:Cholinergic Antagonists; D018727:Muscarinic Antagonists; D022702:Receptors, Adrenergic, beta-3