Real-World Effects of Mirabegron in Patients with Chronic Neurogenic Detrusor Overactivity – A Retrospective Cohort Study

Research and Reports in Urology, 2020 · DOI: http://doi.org/10.2147/RRU.S253713 · Published: January 1, 2020

Simple Explanation

This study investigates the effectiveness and safety of mirabegron, a medication that relaxes bladder muscles, in patients with neurogenic detrusor overactivity (NDO). NDO is a condition causing bladder control problems, often due to neurological issues like spinal cord injury. The study found that mirabegron reduced urinary incontinence and improved bladder capacity and compliance in these patients. No patients had to stop taking mirabegron due to side effects, suggesting it is a well-tolerated treatment option. These results suggest that mirabegron could be a valuable addition to NDO treatment, potentially allowing patients to reduce their reliance on other medications with more significant side effects, like antimuscarinics.

Study Duration

12.7 Months

Participants

63 patients with chronic NDO

Evidence Level

Not specified

Key Findings

1
The number of patients suffering from urinary incontinence significantly decreased from 60.3% to 38.1% during the mirabegron treatment period.
2
Maximum detrusor pressure during the storage phase was significantly lower at the second follow-up evaluation (29.5cmH2O) compared to before the mirabegron treatment (35cmH2O).
3
Bladder capacity and detrusor compliance were significantly increased during the mirabegron treatment.

Research Summary

This retrospective cohort study evaluated the effects of mirabegron on urinary incontinence and urodynamic parameters in patients with chronic neurogenic detrusor overactivity (NDO). The study found that mirabegron significantly reduced urinary incontinence and improved bladder capacity and compliance. The majority of patients received mirabegron in combination with an established antimuscarinic or onabotulinum toxin therapy. Mirabegron demonstrated a clinically relevant effect and a good safety profile. Concomitant treatment of NDO with mirabegron may allow reduction in the dose of antimuscarinic medication and thus, improve the long-term persistence of NDO treatment.

Practical Implications

Improved NDO Treatment

Mirabegron offers a valuable addition to the treatment of NDO, potentially reducing the need for higher doses or more invasive treatments.

Reduced Antimuscarinic Use

The study suggests mirabegron could allow patients to lower their antimuscarinic medication doses, decreasing side effects and improving long-term treatment adherence.

Enhanced Patient Safety

The good safety profile of mirabegron, with few side effects reported, makes it a well-tolerated option for managing NDO symptoms.

Study Limitations

1
Retrospective design
2
Occurrence of side effects may have been underestimated
3
Potential cardiovascular effects of mirabegron are a concern in individuals with a neurologic lesion at the sixth thoracic level or above.

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