Does mirabegron improve the satisfaction of patients with overactive bladder?

This study investigated the effectiveness and impact on patient satisfaction of mirabegron (Myrbetriq) in patients with overactive bladder (OAB). Researchers suggested that this drug improved the treatment satisfaction of patients with OAB.

OAB consists of an uncontrollable need to urinate with or without incontinence (leakage of urine). This condition is usually accompanied by increased urinary frequency and nocturia (waking up at night more than once to urinate). OAB affects the quality of life of affected patients. 

Antimuscarinic drugs are recommended for the treatment of OAB. However, these drugs are associated with negative side effects such as dry mouth, constipation, and blurred vision. Moreover, it can take several weeks to achieve clinical effectiveness. New therapies with fewer side effects are necessary.

Mirabegron is an agonist for beta-3 adrenergic receptors. It relaxes the muscles of the bladder to allow for a larger volume of urine to be stored in between urinations. Prior studies showed that mirabegron reduces incontinence and is associated with fewer side effects. However, there are no studies on patient satisfaction related to mirabegron treatment.

This study included information about 397 patients with OAB treated with antimuscarinics within the last 2 years. These patients expressed dissatisfaction over the poor effectiveness and toxicity of these drugs. All participants received mirabegron 50 mg once a day for 12 weeks as second-line treatment. Follow-up was at 4 and 12 weeks. The main outcome to be measured was patient satisfaction evaluated through questionnaires. 

At 12 weeks, the satisfaction rate was 69.3% (275 out of 397). Significant improvements from the start of the study to weeks 4 and 12 were observed in frequency and urgency. OAB symptoms were also significantly improved.

At week 4, 27.5% of patients reported improvements in symptoms. At week 12, 41.8% of patients reported symptom improvements. At week 12, 80.8% of patients were willing to continue treatment with mirabegron.

This study concluded that mirabegron is associated with patient satisfaction in the treatment of OAB.

This study did not include patients who stopped first-line treatment both for poor effectiveness and side effects. The side effects associated with first-line treatment were not known. Therefore, this study could not confirm if the reason for satisfaction in mirabegron treatment was due to improved effectiveness or fewer side effects. Moreover, this study was funded by Astellas Pharma, the mirabegron manufacturer.