The use of mirabegron in neurogenic bladder: a systematic review

Purpose To evaluate the use of mirabegron in patients with neurogenic bladder. Methods A systematic review of the literature was conducted using four databases (Medline via PubMed, Scopus, Cochrane, and EMBASE). Articles evaluating mirabegron in neurogenic bladder patients were collected, and assess...

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Bibliographic Details
Published in:World journal of urology 2020-10, Vol.38 (10), p.2435-2442
Main Authors: El Helou, Elie, Labaki, Chris, Chebel, Roy, El Helou, Jeanine, Abi Tayeh, Georges, Jalkh, Georges, Nemr, Elie
Format: Article
Language:English
Subjects:
Acetanilides - therapeutic use
Adrenergic beta-3 Receptor Agonists - therapeutic use
Bladder
Humans
Invited Review
Literature reviews
Medicine
Medicine & Public Health
Nephrology
Oncology
Patients
Systematic review
Thiazoles - therapeutic use
Treatment Outcome
Urinary Bladder, Neurogenic - drug therapy
Urology
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Summary:Purpose To evaluate the use of mirabegron in patients with neurogenic bladder. Methods A systematic review of the literature was conducted using four databases (Medline via PubMed, Scopus, Cochrane, and EMBASE). Articles evaluating mirabegron in neurogenic bladder patients were collected, and assessment of the drug’s efficacy was reviewed according to clinical and urodynamic parameters. Results Seven studies were selected and a total of 302 patients with NB were evaluated, ranging from 15 to 66 patients per study. All of the patients had received antimuscarinics as a previous treatment modality. Mirabegron was used as a second-line treatment after antimuscarinics lacked efficacy or caused adverse effects. The duration of the treatments ranged from 4 to 12 weeks. Reported in two studies each, bladder compliance and maximal cystometric capacity were the most commonly improved urodynamic parameters. In the majority of the studies, positive outcomes were reported for clinical scores. Additionally, analysis of the IPSS subscores revealed an improvement of storage symptoms as opposed to voiding symptoms. In all of the studies, mirabegron was well tolerated. Conclusion Mirabegron appears to be an effective treatment in the management of neurogenic bladder unresponsive to antimuscarinics, particularly in patients presenting with storage symptoms. There is still no evidence concerning the use of mirabegron as a first-line therapy for neurogenic bladder.
ISSN:0724-4983
1433-8726
DOI:10.1007/s00345-019-03040-x