A systematic review of 44 randomized controlled trials involving 27 309 patients showed that mirabegron 50 mg was as efficacious as antimuscarinics
in reducing the frequency of micturition and incontinence, but had an incidence of dry mouth and constipation similar to placebo.
Second-line treatments include oral antimuscarinic
drugs or mirabegron, preferably in an extended-release formulation if available to reduce the likelihood of dry mouth from immediate-release formulations.
Behavioral therapy is probably at least as efficacious as antimuscarinics
, but it does not expose patients to the risks of drug therapy.
It has been over 30 years since a new class of oral treatment was available for OAB patients so we are looking forward to being able to offer an effective medication without the more bothersome side effects associated with antimuscarinics
," commented Professor Chris Chapple, Consultant Urological Surgeon at Sheffield Teaching Hospitals and Lead Investigator of the mirabegron 12 month safety and tolerability study.
Persistence and adherence with mirabegron, a new beta-3 receptor agonist, versus antimuscarinics
in overactive bladder: Early experience in Canada.
are the current OAB treatment standard and work by binding to muscarinic receptors in the bladder and inhibiting involuntary bladder contractions.
If approved, mirabegron will be the first in a new class of OAB treatment, offering healthcare professionals an alternative option to antimuscarinics
(currently the only licensed oral treatment option) when treating patients with OAB.
However, the lack of selectivity of antimuscarinics
to the muscarinergic receptors of the bladder muscle and urothelial cells leads to systemic anticholinergic side effects, such as dry mouth, tachycardia, cognitive problems, constipation and accommodation paralysis (i.
The popularity of extended-release antimuscarinics
reflect an effort to eliminate peaks and valleys in frequency, urgency, and urge incontinence.
Influences on treatment choice and perception of current drug therapies including pentosan polysulfate sodium and the antimuscarinics
Efficacy and tolerability of mirabegron in patients who have previously discontinued antimuscarinics
- the current standard of care for OAB[sup.
2]-blockers, omeprazole and antimuscarinics
, as well as on the acid-independent therapy provided by sucralfate and bismuth.
This report looks at asthma, COPD and allergic rhinitis indications; corticosteroids, beta-2 agonists, leukotriene modifiers, antimuscarinics
and antihistamines classes.
Second-line therapy includes oral or cutaneous forms of antimuscarinics
and, because of recent evidence, a [beta]3-adrenergic agonist.
, mirabegron works by improving the storage capacity of the bladder.