Comparing mirabegron with tolterodine and placebo

This study reviewed the results of 8 studies that compared mirabegron (Betmiga) with placebo (a control drug with no active effect) and tolterodine (Detrol) to treat an overactive bladder (OAB). The study found that mirabegron was a safe and effective treatment option for OAB.

OAB refers to a collection of symptoms such as nocturia (getting up to empty the bladder at night), urgency (inability to hold on to urine) and frequency (emptying the bladder too often). Tolterodine is a commonly used medication for OAB that acts on receptors on the bladder to reduce activity. This can have side effects such as dry mouth and constipation. Mirabegron works on different receptors in the bladder and may be a safe and effective alternative.

8 studies were included with 10,248 patients in total. Out of all patients given mirabegron, 600 (5.8%) were given 25 mg, 3168 (30.9%) 50 mg, and 1986 (19.4%) were given 100 mg. 2,138 patiens (20.8%) received tolterodine. 2,356 patients (23.1%) were given placebo.

Mirabegron 50 mg and 100 mg reduced incontinence (leaking urine) significantly more compared to placebo. Mirabegron 100 mg and 50 mg were not significantly different. Mirabegron 50 mg and 100 mg and tolterodine were more effective than placebo at reducing the number of micturitions (bladder emptying). There were no differences in micturitions between tolterodine and any dose of mirabegron. All drugs and doses given showed significant increase in the amount of urine passed. There were no significant differences among treatment groups.

All drug treatments reduced urgency compared to placebo. No differences were seen between active treatment groups. Mirabegron 50 mg was found to significantly reduce nocturia. However, the reduction was smaller in the 100 mg dose. Tolterodine was not more effective than placebo in reducing nocturia.

Mirabegron 50 mg did not increase risk of side effects compared with placebo. The 100 mg dose showed a small increase in the chance of high blood pressure and heart problems. Tolterodine had a 38% increase chance of side effects such as dry mouth.

This review concluded that mirabegron was a safe and effective treatment for OAB symptoms.

Many of these studies received funding from the drug manufacturers.

Talk to your doctor about using mirabegron to treat bladder and urinary symptoms.