Real-World Effects of Mirabegron in Patients with Chronic Neurogenic Detrusor Overactivity – A Retrospective Cohort Study
Real-World Effects of Mirabegron in Patients with Chronic Neurogenic Detrusor Overactivity – A Retrospective Cohort Study
Blog Article
Jörg Krebs,1 Jürgen Pannek,2,3 Franziska Rademacher,2 Jens Wöllner2 1Clinical Trial Unit, Swiss Paraplegic Centre, Nottwil, Switzerland; 2Neuro-Urology, Swiss Paraplegic Centre, Nottwil, Switzerland; 3Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, SwitzerlandCorrespondence: Jürgen PannekNeuro-Urology, Swiss Paraplegic Centre, Guido A.Zäch Str.1, Nottwil CH-6207, SwitzerlandTel +41 41 939 5922Fax +41 41 939 5923Email [email protected]: To investigate the tolerability and the effects of the β-3-adrenoceptor-agonist mirabegron on urinary incontinence and urodynamic parameters in patients with chronic neurogenic detrusor overactivity (NDO).
Patients and Methods: The patient database of a spinal cord injury rehabilitation center in Switzerland was screened for patients with chronic (> 12 months) NDO, who had been prescribed mirabegron.Patient characteristics, data regarding bladder management, urinary incontinence and concurrent medication for NDO as well as urodynamic parameters color touch 7/97 were collected retrospectively.The changes in the urodynamic parameters and the occurrence of urinary incontinence over time were investigated.Results: The data of 63 patients with a median age of 48 years and a median NDO duration of 8.9 years at the initiation of the mirabegron treatment were analyzed.
A median 3.0 and 12.7 months had elapsed from the initiation of the mirabegron therapy to the first and second follow-up evaluation, respectively.The majority of patients (73%) received mirabegron in combination with an established antimuscarinic or onabotulinum toxin therapy.The number of patients suffering from urinary incontinence decreased significantly (p≤ 0.
005) from 60.3% (95% CI 47.2/72.4%) to 38.1% (95% CI 23.
6/54.4%).Furthermore, the maximum detrusor pressure during the storage phase was significantly (p≤ 0.04) lower at the second follow-up evaluation (29.5cmH2O, 95% CI 22/40cmH2O) compared to before the mirabegron treatment (35cmH2O, 95% CI 29/41cmH2O).
The bladder capacity and detrusor compliance were significantly (p≤ 0.005) increased during the mirabegron treatment.No patient had discontinued the mirabegron treatment as a result of side effects.Conclusion: Mirabegron demonstrated a clinically relevant effect and a good safety profile.Concomitant treatment of NDO with trailmaster challenger 200x mirabegron may allow reduction in the dose of antimuscarinic medication and thus, improve the long-term persistence of NDO treatment.
Keywords: spinal cord injury, detrusor overactivity, neurogenic lower urinary tract dysfunction, antimuscarinics, onabotulinum toxin.