title: The efficacy and tolerability of mirabegron, a β3 adrenoceptor agonist, in patients with symptoms of overactive bladder.
abstract: Mirabegron, is the only β-3 adrenoreceptor (AR) agonist available for the treatment of overactive bladder (OAB). To assess the efficacy and tolerability of this novel drug therapy, two phase II and six phase III Astellas-sponsored trials have been conducted with over 10,500 adults with OAB recruited. Of these, seven were randomized, double blind, 12-week placebo controlled studies and the other was for 12 months and not placebo controlled. The evidence described would suggest that mirabegron is as efficacious as most antimuscarinics, including tolterodine extended release (ER) 4 mg, compared with placebo with regard to objective measures such as reduction in number of voids per 24 hours, mean volume per void, mean number of episodes of general urinary incontinence, urgency urinary incontinence and urgency per 24 hours; and subjective measures such as severity of urgency, patient perception of bladder condition and validated continence quality of life questionnaires. Regarding tolerability, these data would suggest that patients taking mirabegron suffer a similar rate of adverse effects as those taking placebo alone, whereas the rate in those taking antimuscarinics is greater. Thus mirabegron presents a safe and effective alternative treatment to antimuscarinics for patients with OAB symptoms. Patients who may particularly benefit from mirabegron include those who are unsuitable for antimuscarinics or who have previously struggled with antimuscarinic side effects.
authors.affiliation: Urogynaecology Department, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
authors.forename: Ganesh
authors.initials: G
authors.lastname: Thiagamoorthy
authors.affiliation: Mater Dei Hospital, Msida, Malta.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Kotes
authors.affiliation: King's College Hospital, London, UK.
authors.forename: Martino
authors.initials: M
authors.lastname: Zacchè
authors.affiliation: King's College Hospital, London, UK.
authors.forename: Linda
authors.initials: L
authors.lastname: Cardozo
keywords: drug therapy; mirabegron; overactive bladder (OAB); urgency; urinary incontinence
references.citation: Eur Urol. 2006 Aug;50(2):211-2
references.pmid: 16632192
references.citation: Nat Rev Neurosci. 2008 Jun;9(6):453-66
references.pmid: 18490916
references.citation: BMC Urol. 2012 Sep 07;12:26
references.pmid: 22958621
references.citation: Res Rep Urol. 2013 Dec 06;6:1-16
references.pmid: 24400248
references.citation: World J Urol. 2003 May;20(6):327-36
references.pmid: 12811491
references.citation: Urology. 2003 Nov;62(5 Suppl 2):28-37; discussion 40-2
references.pmid: 14662404
references.citation: Neurourol Urodyn. 2010;29(1):112-5
references.pmid: 19693952
references.citation: BJU Int. 2014 Jun;113(6):951-60
references.pmid: 24471907
references.citation: Eur Urol. 2006 Aug;50(2):317-26
references.pmid: 16687205
references.citation: Cochrane Database Syst Rev. 2012 Jan 18;1:CD005429
references.pmid: 22258963
references.citation: Eur Urol. 2013 Feb;63(2):296-305
references.pmid: 23195283
references.citation: Int Urogynecol J. 2010 Jan;21(1):5-26
references.pmid: 19937315
references.citation: Cochrane Database Syst Rev. 2006 Oct 18;(4):CD003781
references.pmid: 17054185
references.citation: Urol Int. 2014;93(3):326-37
references.pmid: 25115445
references.citation: J Pharmacol Exp Ther. 2007 May;321(2):642-7
references.pmid: 17293563
references.citation: Acta Physiol Scand. 1998 Sep;164(1):117-8
references.pmid: 9777033
references.citation: Int J Clin Pract. 2011 May;65(5):567-85
references.pmid: 21489081
references.citation: Age Ageing. 2014 Sep;43(5):666-75
references.pmid: 24610862
references.citation: J Urol. 2014 Apr;191(4):1003-8
references.pmid: 24140548
references.citation: Urology. 2013 Aug;82(2):313-20
references.pmid: 23769122
references.citation: IDrugs. 2010 Oct;13(10):713-22
references.pmid: 20878594
references.citation: Eur J Drug Metab Pharmacokinet. 2014 Mar;39(1):43-52
references.pmid: 23728524
references.citation: Eur Urol. 2014 Apr;65(4):755-65
references.pmid: 24275310
references.citation: Neurourol Urodyn. 2015 Sep;34(7):685-92
references.pmid: 25130281
references.citation: J Urol. 2001 Jan;165(1):240-4
references.pmid: 11125417
references.citation: Eur Urol. 2015 Mar;67(3):577-88
references.pmid: 24612659
references.citation: BJU Int. 2001 Jun;87(9):760-6
references.pmid: 11412210
references.citation: JAMA Intern Med. 2015 Mar;175(3):401-7
references.pmid: 25621434
references.citation: Lancet Neurol. 2004 Jan;3(1):46-53
references.pmid: 14693111
references.citation: J Urol. 2013 Apr;189(4):1388-95
references.pmid: 23079373
references.citation: Eur Urol. 2006 Mar;49(3):544-50
references.pmid: 16387416
references.citation: Prog Urol. 2014 Sep;24(11):672-81
references.pmid: 25214448
references.citation: Neurourol Urodyn. 2013 Nov;32(8):1116-22
references.pmid: 23424164
references.citation: Expert Opin Pharmacother. 2014 Apr;15(6):873-87
references.pmid: 24646053
references.citation: BJU Int. 2009 Aug;104(3):352-60
references.pmid: 19281467
references.citation: Naunyn Schmiedebergs Arch Pharmacol. 2012 Aug;385(8):759-67
references.pmid: 22644105
references.citation: Int Urogynecol J. 2014 Feb;25(2):165-70
references.pmid: 23922008
references.citation: Eur Urol. 2013 Feb;63(2):283-95
references.pmid: 23182126
references.citation: BJU Int. 2012 Dec;110(11):1767-74
references.pmid: 22409769
references.citation: Int Urogynecol J. 2013 Sep;24(9):1447-58
references.pmid: 23471546