Investig Clin Urol.  2017 Jul;58(4):261-266. 10.4111/icu.2017.58.4.261.

Additional low-dose antimuscarinics can improve overactive bladder symptoms in patients with suboptimal response to beta 3 agonist monotherapy

• Shin JH
• Kim A
• Choo MS

• KMID: 2410293
• DOI: http://doi.org/10.4111/icu.2017.58.4.261

Abstract

PURPOSE
We aimed to assess the patient-reported outcome (PRO) and efficacy of add-on low-dose antimuscarinic therapy in over-active bladder (OAB) patients with suboptimal response to 4-week treatment with beta 3 agonist monotherapy (mirabegron, 50 mg).
MATERIALS AND METHODS
We enrolled OAB patients with 4-week mirabegron (50 mg) treatment if the patients' symptoms improved, but not to a satisfactory extent (patient perception of bladder condition [PPBC] ≥4). Enrolled patients had 8-week low-dose antimuscarinics add-on therapy (propiverine HCl, 10 mg). Patients recorded 3-day voiding diary at screening, enrollment (after 4 weeks of mirabegron monotherapy) and after 8 weeks of add-on therapy. We assessed the change of PRO (PPBC) as a primary end point and the efficacy of add-on therapy (change of frequency, urgency, urinary urgency incontinence [UUI] based on voiding diary) as a secondary end point.
RESULTS
Thirty patients (mean age, 62.3±12.8 years; mean symptom duration, 16.0±12.3 months) were finally enrolled in the study. The mean PPBC value was 4.3±0.4 after mirabegron monotherapy, and decreased to 3.2±1.0 after 8-week add-on therapy. The mean urinary frequency decreased from 10.1±3.1 to 8.8±3, the mean number of urgency episodes decreased from 3.6±1.6 to 1.8±1.2 and the number of urgency incontinence episodes decreased from 0.7±1.0 to 0.2±0.5 after add-on therapy. No patients had event of acute urinary retention and three patients complained of mild dry mouth after add-on therapy.
CONCLUSIONS
Add-on therapy of low-dose antimuscarinics exhibits good efficacy and safety in patients with suboptimal response after 4-week of mirabegron (50 mg) monotherapy.

Keyword

Antimuscarinics; Mirabegron; Overactive urinary bladder

MeSH Terms

Humans
Mass Screening
Mouth
Muscarinic Antagonists*
Urinary Bladder
Urinary Bladder, Overactive*
Urinary Retention
Muscarinic Antagonists

Figure

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  Fig. 1 Study design.

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  Fig. 2 Change of patient perception of bladder condition and frequency after monotherapy and add-on therapy.

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  Fig. 3 Change of urinary frequency (A), urgency (B), urgency incontinence (C) episodes.

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