The efficacy of mirabegron in the treatment of urgency and the potential utility of combination therapy

Karl-Erik Andersson; Nurul Choudhury; Jean-Nicolas Cornu; Moses Huang; Cees Korstanje; Emad Siddiqui; Philip Van Kerrebroeck

doi:10.1177/1756287218781255

The efficacy of mirabegron in the treatment of urgency and the potential utility of combination therapy

Karl-Erik Andersson, Nurul Choudhury^*, Jean-Nicolas Cornu, Moses Huang, Cees Korstanje, Emad Siddiqui, Philip Van Kerrebroeck

^*Corresponding author for this work

Research output: Contribution to journal › (Systematic) Review article › peer-review

Abstract

Urgency is the prevalent and most bothersome symptom of overactive bladder (OAB) and the treatment of urgency is the primary objective in the management of OAB. Urgency has a major impact on other symptoms of OAB and culminates in an increased frequency of micturition and reduced volume voided, which may contribute to shorter intervals between the need to void. Antimuscarinic agents and mirabegron, a (3)-adrenoceptor agonist, constitute the main oral pharmacotherapeutic options for the treatment of urgency and other OAB symptoms. The reduction of urgency and other OAB symptoms significantly improve health-related quality of life. This review will explore the distinct mechanisms of action and effects of antimuscarinic agents and mirabegron, in relation to their effect on the pathophysiology of urgency. The review will also provide an overview of the various validated measurements of urgency and the numerous clinical trials regarding antimuscarinic agent monotherapy, mirabegron monotherapy, or combination treatment with mirabegron added on to the antimuscarinic agent solifenacin. A narrative review of the literature relating to pathophysiology of urgency, the validated measurements of urgency, and clinical trials relating to the pharmacological treatment of urgency. Antimuscarinic agent monotherapy, mirabegron monotherapy, or combination treatment with mirabegron added on to the antimuscarinic agent solifenacin statistically significantly reduce the symptoms of urgency compared with placebo. Combination therapy with mirabegron added on to solifenacin also statistically significantly reduces the symptoms of severe urgency compared with antimuscarinic agent monotherapy. A critique of the clinical benefits of combination therapy is also provided. Combination therapy provides an alternative treatment in patients with OAB that includes urgency who respond poorly to first-line monotherapy and who may otherwise often move on to more invasive treatments.

Original language	English
Pages (from-to)	243-256
Number of pages	14
Journal	Therapeutic Advances in Urology
Volume	10
Issue number	8
DOIs	https://doi.org/10.1177/1756287218781255
Publication status	Published - 1 Aug 2018

Keywords

antimuscarinic
combination therapy
mirabegron
overactive bladder
urgency
OVERACTIVE BLADDER SYNDROME
LOWER URINARY-TRACT
ANTIMUSCARINIC AGENT SOLIFENACIN
MUSCARINIC RECEPTOR SUBTYPES
PROPIVERINE-CONTROLLED TRIAL
PLACEBO-CONTROLLED TRIAL
DOUBLE-BLIND TRIAL
JAPANESE PATIENTS
AFFERENT ACTIVITY
EXTENDED-RELEASE

Access to Document

10.1177/1756287218781255

Cite this

@article{e3c2ad559ce5447fbeb1019c7e58fe0b,

title = "The efficacy of mirabegron in the treatment of urgency and the potential utility of combination therapy",

abstract = "Urgency is the prevalent and most bothersome symptom of overactive bladder (OAB) and the treatment of urgency is the primary objective in the management of OAB. Urgency has a major impact on other symptoms of OAB and culminates in an increased frequency of micturition and reduced volume voided, which may contribute to shorter intervals between the need to void. Antimuscarinic agents and mirabegron, a (3)-adrenoceptor agonist, constitute the main oral pharmacotherapeutic options for the treatment of urgency and other OAB symptoms. The reduction of urgency and other OAB symptoms significantly improve health-related quality of life. This review will explore the distinct mechanisms of action and effects of antimuscarinic agents and mirabegron, in relation to their effect on the pathophysiology of urgency. The review will also provide an overview of the various validated measurements of urgency and the numerous clinical trials regarding antimuscarinic agent monotherapy, mirabegron monotherapy, or combination treatment with mirabegron added on to the antimuscarinic agent solifenacin. A narrative review of the literature relating to pathophysiology of urgency, the validated measurements of urgency, and clinical trials relating to the pharmacological treatment of urgency. Antimuscarinic agent monotherapy, mirabegron monotherapy, or combination treatment with mirabegron added on to the antimuscarinic agent solifenacin statistically significantly reduce the symptoms of urgency compared with placebo. Combination therapy with mirabegron added on to solifenacin also statistically significantly reduces the symptoms of severe urgency compared with antimuscarinic agent monotherapy. A critique of the clinical benefits of combination therapy is also provided. Combination therapy provides an alternative treatment in patients with OAB that includes urgency who respond poorly to first-line monotherapy and who may otherwise often move on to more invasive treatments.",

keywords = "antimuscarinic, combination therapy, mirabegron, overactive bladder, urgency, OVERACTIVE BLADDER SYNDROME, LOWER URINARY-TRACT, ANTIMUSCARINIC AGENT SOLIFENACIN, MUSCARINIC RECEPTOR SUBTYPES, PROPIVERINE-CONTROLLED TRIAL, PLACEBO-CONTROLLED TRIAL, DOUBLE-BLIND TRIAL, JAPANESE PATIENTS, AFFERENT ACTIVITY, EXTENDED-RELEASE",

author = "Karl-Erik Andersson and Nurul Choudhury and Jean-Nicolas Cornu and Moses Huang and Cees Korstanje and Emad Siddiqui and {Van Kerrebroeck}, Philip",

year = "2018",

month = aug,

day = "1",

doi = "10.1177/1756287218781255",

language = "English",

volume = "10",

pages = "243--256",

journal = "Therapeutic Advances in Urology",

issn = "1756-2872",

publisher = "SAGE Publications Ltd",

number = "8",

}

TY - JOUR

T1 - The efficacy of mirabegron in the treatment of urgency and the potential utility of combination therapy

AU - Andersson, Karl-Erik

AU - Choudhury, Nurul

AU - Cornu, Jean-Nicolas

AU - Huang, Moses

AU - Korstanje, Cees

AU - Siddiqui, Emad

AU - Van Kerrebroeck, Philip

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Urgency is the prevalent and most bothersome symptom of overactive bladder (OAB) and the treatment of urgency is the primary objective in the management of OAB. Urgency has a major impact on other symptoms of OAB and culminates in an increased frequency of micturition and reduced volume voided, which may contribute to shorter intervals between the need to void. Antimuscarinic agents and mirabegron, a (3)-adrenoceptor agonist, constitute the main oral pharmacotherapeutic options for the treatment of urgency and other OAB symptoms. The reduction of urgency and other OAB symptoms significantly improve health-related quality of life. This review will explore the distinct mechanisms of action and effects of antimuscarinic agents and mirabegron, in relation to their effect on the pathophysiology of urgency. The review will also provide an overview of the various validated measurements of urgency and the numerous clinical trials regarding antimuscarinic agent monotherapy, mirabegron monotherapy, or combination treatment with mirabegron added on to the antimuscarinic agent solifenacin. A narrative review of the literature relating to pathophysiology of urgency, the validated measurements of urgency, and clinical trials relating to the pharmacological treatment of urgency. Antimuscarinic agent monotherapy, mirabegron monotherapy, or combination treatment with mirabegron added on to the antimuscarinic agent solifenacin statistically significantly reduce the symptoms of urgency compared with placebo. Combination therapy with mirabegron added on to solifenacin also statistically significantly reduces the symptoms of severe urgency compared with antimuscarinic agent monotherapy. A critique of the clinical benefits of combination therapy is also provided. Combination therapy provides an alternative treatment in patients with OAB that includes urgency who respond poorly to first-line monotherapy and who may otherwise often move on to more invasive treatments.

AB - Urgency is the prevalent and most bothersome symptom of overactive bladder (OAB) and the treatment of urgency is the primary objective in the management of OAB. Urgency has a major impact on other symptoms of OAB and culminates in an increased frequency of micturition and reduced volume voided, which may contribute to shorter intervals between the need to void. Antimuscarinic agents and mirabegron, a (3)-adrenoceptor agonist, constitute the main oral pharmacotherapeutic options for the treatment of urgency and other OAB symptoms. The reduction of urgency and other OAB symptoms significantly improve health-related quality of life. This review will explore the distinct mechanisms of action and effects of antimuscarinic agents and mirabegron, in relation to their effect on the pathophysiology of urgency. The review will also provide an overview of the various validated measurements of urgency and the numerous clinical trials regarding antimuscarinic agent monotherapy, mirabegron monotherapy, or combination treatment with mirabegron added on to the antimuscarinic agent solifenacin. A narrative review of the literature relating to pathophysiology of urgency, the validated measurements of urgency, and clinical trials relating to the pharmacological treatment of urgency. Antimuscarinic agent monotherapy, mirabegron monotherapy, or combination treatment with mirabegron added on to the antimuscarinic agent solifenacin statistically significantly reduce the symptoms of urgency compared with placebo. Combination therapy with mirabegron added on to solifenacin also statistically significantly reduces the symptoms of severe urgency compared with antimuscarinic agent monotherapy. A critique of the clinical benefits of combination therapy is also provided. Combination therapy provides an alternative treatment in patients with OAB that includes urgency who respond poorly to first-line monotherapy and who may otherwise often move on to more invasive treatments.

KW - antimuscarinic

KW - combination therapy

KW - mirabegron

KW - overactive bladder

KW - urgency

KW - OVERACTIVE BLADDER SYNDROME

KW - LOWER URINARY-TRACT

KW - ANTIMUSCARINIC AGENT SOLIFENACIN

KW - MUSCARINIC RECEPTOR SUBTYPES

KW - PROPIVERINE-CONTROLLED TRIAL

KW - PLACEBO-CONTROLLED TRIAL

KW - DOUBLE-BLIND TRIAL

KW - JAPANESE PATIENTS

KW - AFFERENT ACTIVITY

KW - EXTENDED-RELEASE

U2 - 10.1177/1756287218781255

DO - 10.1177/1756287218781255

M3 - (Systematic) Review article

C2 - 30034543

SN - 1756-2872

VL - 10

SP - 243

EP - 256

JO - Therapeutic Advances in Urology

JF - Therapeutic Advances in Urology

IS - 8

ER -