Does metabolic syndrome influence the efficacy of mirabegron treatment in female patients with overactive bladder?

• Published in: International Urogynecology Journal 2023-04, Vol.34 (4), p.853-859
• Main Authors: Kinjo, Manami, Masuda, Kazuki, Nakamura, Yu, Taguchi, Satoru, Tambo, Mitsuhiro, Fukuhara, Hiroshi
• Format: Article
• Language: English
• Subjects: Acetanilides - therapeutic use; Bladder; Body mass index; Cardiovascular disease; Female; Gynecology; Humans; Hyperglycemia; Hypertension; Medicine; Medicine & Public Health; Metabolic syndrome; Metabolic Syndrome - complications; Obesity; Original Article; Regression analysis; Risk factors; Statistical significance; Treatment Outcome; Urinary Bladder, Overactive - complications; Urinary Bladder, Overactive - diagnosis; Urinary Bladder, Overactive - drug therapy; Urogenital system; Urological Agents - therapeutic use; Urology; Womens health
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-022-05261-y

Introduction and hypothesis We aimed to determine whether the presence of metabolic syndrome (MS) affects the efficacy of mirabegron in treatment-naïve women with overactive bladder (OAB). Methods Women being treated with mirabegron 50 mg were allocated to MS and non-MS groups, and the efficacy of treatment of OAB was compared using the OAB symptom score (OABSS) and a 3-day voiding diary before and 12 weeks after starting treatment. The Wilcoxon signed-rank and Mann-Whitney U tests and multivariate logistic regression were used for statistical analyses, and a p -value < 0.05 was considered to represent statistical significance. Results Of the 197 patients who completed the trial, 43 (23.9%) had MS. After 12 weeks of mirabegron treatment, both the MS and non-MS groups showed significant improvements in OABSS score, the number of incontinence episodes/24 h, the number of micturition episodes/24 h, and the number of episodes of urgency/24 h. The factors associated with clinically important differences in OABSS were the presence of hyperglycemia (odds ratio 2.43, 95% confidence interval [CI] 1.05–5.60) and OABSS score at baseline (odds ratio 1.23, 95% CI 1.09–1.39). Conclusions Mirabegron is effective in patients with and without MS, and comorbid hyperglycemia and severe OAB symptoms before treatment are predictors of the efficacy of mirabegron treatment.