Background
Mirabegron, a β3-adrenoreceptor agonist, is an alternative drug to antimuscarinics for overactive bladder (OAB) symptoms.
Objective
To summarise safety and efficacy reporting of mirabegron treatment for OAB symptoms.
Design, setting, and participants
Pooled data analysed from 10 phase 2–4, double-blind, 12-wk mirabegron monotherapy studies in adults with OAB who had received one or more doses of study drug.
Intervention
Mirabegron: 25 and 50 mg; antimuscarinics: solifenacin (2.5, 5, and 10 mg) and tolterodine extended release (4 mg).
Outcome measurements and statistical analysis
Baseline OAB-related characteristics, intrinsic and extrinsic factors, and analyses by age (<65 vs ≥65 yr and <75 vs ≥75 yr) and sex were assessed. Solifenacin 2.5 and 10 mg groups were not included in the efficacy analyses (small patient numbers). Safety was evaluated using the proportion of treatment-emergent adverse events. Efficacy variables were derived from bladder diaries (baseline and week 12).
Results and limitations
Baseline hypertension and diabetes were more frequent across treatment groups in the older versus younger age groups and in men versus women. Within sexes, frequencies were similar between treatment groups. Some differences were observed in baseline characteristics, including type of incontinence and medical history between sexes. No previously unreported safety concerns were identified. Improvements in efficacy (mean number of incontinence episodes/24 h, micturitions/24 h, urgency episodes/24 h, volume voided/micturition, and nocturia episodes) versus placebo were observed in all treatment groups. Significant treatment-by-subgroup interactions included change from baseline in the mean number of incontinence episodes/24 h by age (<65 vs ≥65 yr), nocturia by age (<65 vs ≥65 yr and <75 vs ≥75 yr), and urgency episodes by previous OAB medication.
Conclusions
Data from this integrated database of 10 mirabegron studies reaffirm the safety and efficacy profiles of mirabegron, solifenacin, and tolterodine in adults of different age groups and sexes.
