Long-Term Efficacy of Mirabegron Add-On Therapy to Antimuscarinic Agents in Patients With Spinal Cord Injury

Overview

Journal Ann Rehabil Med

Specialty Rehabilitation Medicine

Date 2019 Mar 12

PMID 30852871

Citations 2

Authors

Seok-Hee Han

In Kyoung Cho

Joo Hwan Jung

Seong Ho Jang

Bum-Suk Lee

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate the long-term efficacy of mirabegron add-on therapy in patients with spinal cord injury (SCI) based on an urodynamic study.

Methods: This retrospective study involved a chart audit of individuals with SCI who underwent two consecutive urodynamic studies between April 1, 2015 and April 1, 2018. After adding 50 mg of mirabegron once a day to the pre-existing antimuscarinic therapy for a period of, at least 6 months, the following variables were analyzed: change in cystometric capacity, change in bladder compliance, change in maximal detrusor pressure, change in reflex volume, and presence of significant leakage during filling cystometry.

Results: A total of 31 participants with a mean age of 41±15 years were included in the analysis. A significant increase in cystometric capacity (mean, 362 to 424 mL; p=0.03), reflex volume (mean, 251 to 329 mL; p=0.02), and bladder compliance (median, 12 to 18 mL/cmH2O; p=0.04) was observed. The presence of leakage during filling cystometry was significantly reduced (29% to 10%; p=0.03). Likewise, a non-significant decrease in the change in maximal detrusor pressure was observed (mean, 31 to 27 cmH2O; p=0.39).

Conclusion: Adding mirabegron to conventional antimuscarinics further improved urodynamic parameters in patients with chronic SCI, and sustained efficacy was observed in long-term use.

Citing Articles

Drug Repurposing for Spinal Cord Injury: Progress Towards Therapeutic Intervention for Primary Factors and Secondary Complications.

Guha L, Kumar H Pharmaceut Med. 2023; 37(6):463-490.

PMID: 37698762 DOI: 10.1007/s40290-023-00499-3.

Lower urinary tract dysfunction in common neurological diseases.

Moussa M, Papatsoris A, Chakra M, Fares Y, Dellis A Turk J Urol. 2020; 46(Supp. 1):S70-S78.

PMID: 32384046 PMC: 7731959. DOI: 10.5152/tud.2020.20092.

References

Takeda M, Obara K, MIZUSAWA T, Tomita Y, Arai K, Tsutsui T . Evidence for beta3-adrenoceptor subtypes in relaxation of the human urinary bladder detrusor: analysis by molecular biological and pharmacological methods. J Pharmacol Exp Ther. 1999; 288(3):1367-73. View

Yamaguchi O . Beta3-adrenoceptors in human detrusor muscle. Urology. 2002; 59(5 Suppl 1):25-9. DOI: 10.1016/s0090-4295(01)01635-1. View

Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U . The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology. 2003; 61(1):37-49. DOI: 10.1016/s0090-4295(02)02243-4. View

Staskin D, MacDiarmid S . Using anticholinergics to treat overactive bladder: the issue of treatment tolerability. Am J Med. 2006; 119(3 Suppl 1):9-15. DOI: 10.1016/j.amjmed.2005.12.011. View

Nitti V, Dmochowski R, Appell R, Wang J, Bavendam T, Guan Z . Efficacy and tolerability of tolterodine extended-release in continent patients with overactive bladder and nocturia. BJU Int. 2006; 97(6):1262-6. DOI: 10.1111/j.1464-410X.2006.06146.x. View

Stohrer M, Murtz G, Kramer G, Schnabel F, Arnold E, Wyndaele J . Propiverine compared to oxybutynin in neurogenic detrusor overactivity--results of a randomized, double-blind, multicenter clinical study. Eur Urol. 2006; 51(1):235-42. DOI: 10.1016/j.eururo.2006.03.016. View

Abrams P, Artibani W, Gajewski J, Hussain I . Assessment of treatment outcomes in patients with overactive bladder: importance of objective and subjective measures. Urology. 2006; 68(2 Suppl):17-28. DOI: 10.1016/j.urology.2006.05.044. View

Gerridzen R, Thijssen A, Dehoux E . Risk factors for upper tract deterioration in chronic spinal cord injury patients. J Urol. 1992; 147(2):416-8. DOI: 10.1016/s0022-5347(17)37254-3. View

Amend B, Hennenlotter J, Schafer T, Horstmann M, Stenzl A, Sievert K . Effective treatment of neurogenic detrusor dysfunction by combined high-dosed antimuscarinics without increased side-effects. Eur Urol. 2008; 53(5):1021-8. DOI: 10.1016/j.eururo.2008.01.007. View

10.

Stohrer M, Blok B, Castro-Diaz D, Chartier-Kastler E, Del Popolo G, Kramer G . EAU guidelines on neurogenic lower urinary tract dysfunction. Eur Urol. 2009; 56(1):81-8. DOI: 10.1016/j.eururo.2009.04.028. View

11.

Benner J, Nichol M, Rovner E, Jumadilova Z, Alvir J, Hussein M . Patient-reported reasons for discontinuing overactive bladder medication. BJU Int. 2009; 105(9):1276-82. DOI: 10.1111/j.1464-410X.2009.09036.x. View

12.

Del Popolo G, Mencarini M, Nelli F, Lazzeri M . Controversy over the pharmacological treatments of storage symptoms in spinal cord injury patients: a literature overview. Spinal Cord. 2011; 50(1):8-13. DOI: 10.1038/sc.2011.110. View

13.

Kirshblum S, Waring W, Biering-Sorensen F, Burns S, Johansen M, Schmidt-Read M . Reference for the 2011 revision of the International Standards for Neurological Classification of Spinal Cord Injury. J Spinal Cord Med. 2012; 34(6):547-54. PMC: 3232637. DOI: 10.1179/107902611X13186000420242. View

14.

Madhuvrata P, Singh M, Hasafa Z, Abdel-Fattah M . Anticholinergic drugs for adult neurogenic detrusor overactivity: a systematic review and meta-analysis. Eur Urol. 2012; 62(5):816-30. DOI: 10.1016/j.eururo.2012.02.036. View

15.

Krebs J, Pannek J . Effects of solifenacin in patients with neurogenic detrusor overactivity as a result of spinal cord lesion. Spinal Cord. 2012; 51(4):306-9. DOI: 10.1038/sc.2012.164. View

16.

Kim J, Seo B . How to calculate sample size and why. Clin Orthop Surg. 2013; 5(3):235-42. PMC: 3758995. DOI: 10.4055/cios.2013.5.3.235. View

17.

Maman K, Aballea S, Nazir J, Desroziers K, Neine M, Siddiqui E . Comparative efficacy and safety of medical treatments for the management of overactive bladder: a systematic literature review and mixed treatment comparison. Eur Urol. 2013; 65(4):755-65. DOI: 10.1016/j.eururo.2013.11.010. View

18.

Ginsberg D . The epidemiology and pathophysiology of neurogenic bladder. Am J Manag Care. 2014; 19(10 Suppl):s191-6. View

19.

Kirshblum S, Waring 3rd W . Updates for the International Standards for Neurological Classification of Spinal Cord Injury. Phys Med Rehabil Clin N Am. 2014; 25(3):505-17, vii. DOI: 10.1016/j.pmr.2014.04.001. View

20.

Goldmark E, Niver B, Ginsberg D . Neurogenic bladder: from diagnosis to management. Curr Urol Rep. 2014; 15(10):448. DOI: 10.1007/s11934-014-0448-8. View