Ann Rehabil Med.  2019 Feb;43(1):54-61. 10.5535/arm.2019.43.1.54.

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

• Han SH
• Cho IK
• Jung JH
• Jang SH
• Lee BS

• KMID: 2440952
• DOI: http://doi.org/10.5535/arm.2019.43.1.54

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/cmHâ‚‚O; 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 cmHâ‚‚O; 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.

Keyword

Spinal cord injuries; Urodynamics; Mirabegron; Muscarinic antagonists

MeSH Terms

Compliance
Humans
Muscarinic Antagonists*
Reflex
Retrospective Studies
Spinal Cord Injuries*
Spinal Cord*
Urinary Bladder
Urodynamics
Muscarinic Antagonists

Figure

• 

  Fig. 1. Changes in cystometric capacity (A), reflex volume (B), maximal detrusor pressure (C), and leakage during filling cystometry (D) in participants before and after adding mirabegron (50 mg a day). *p<0.05.

• 

  Fig. 2. Box plots of compliance (mL/cmH2O) in participants before and after adding mirabegron (50 mg a day). *p<0.05.

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