title: Is mirabegron equally as effective when used as first- or second-line therapy in women with overactive bladder?
abstract: OBJECTIVE
  No previous studies have investigated the efficacy of mirabegron 50 mg as the first-line therapy in OAB patients. Hence, the primary objective of this study was to evaluate the efficacy of mirabegron in treatment-naive patients in comparison with those who had discontinued antimuscarinic therapy because of insufficient efficacy.
  
  
  METHODS
  All consecutive women who had pure OAB symptoms (including urgency with or without urgency incontinence and frequency) for at least 3 months were considered for this study. Women were divided into two groups: women without any previous pharmacological treatment for OAB (group 1) and women with a previous history of failed antimuscarinics therapy (group 2).
  
  
  RESULTS
  At 3-month follow-up, the objective results on the basis of the frequency-volume chart showed a significant improvement in both groups. Furthermore, a significant reduction in the Overactive Bladder Questionnaire Short Form (OABq-SF) score and in the Indevus Urgency Severity Scale (IUSS) questionnaire were reported in both groups. However, the improvement in objective and subjective outcomes was superior in group 1 to that in group 2.
  
  
  CONCLUSIONS
  Mirabegron is efficacious in improving OAB symptoms in both naïve patients and those who discontinued primary antimuscarinic therapy; however, its efficacy is superior when prescribed as first-line therapy.
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Serati
authors.affiliation: Academic Unit of Obstetrics and Gynaecology, IRCCS AOU San Martino-IST, Largo R. Benzi 10, 16132, Genoa, Italy. ulrm@me.com.|Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy. ulrm@me.com.
authors.forename: Umberto
authors.initials: U
authors.lastname: Leone Roberti Maggiore
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Sorice
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Cantaluppi
authors.affiliation: Department of Experimental Medicine and Surgery, University Tor Vergata, Rome, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Finazzi Agrò
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Ghezzi
mesh_terms: D000083:Acetanilides / Q000008:administration & dosage*; D058667:Adrenergic beta-3 Receptor Agonists / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D013844:Thiazoles / Q000008:administration & dosage*; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*
chemical_list: D000083:Acetanilides; D058667:Adrenergic beta-3 Receptor Agonists; D013844:Thiazoles; C520025:mirabegron
keywords: Antimuscarinic; Female; Medical treatment; Mirabegron; Overactive bladder