Editorial commentary on Safety and Efficacy of Mirabegron: Analysis of a Large Integrated Clinical Trial Database of Patients with Overactive Bladder Receiving Mirabegron Antimuscarinics or Placebo

摘要

For the treatment of overactive bladder (OAB), physiotherapy and pharmaceutical therapies have been the main treatments of choice. The mainstays of medical therapy for OAB are antimuscarinics (AMs) and β3-adorenoceptor (AR) agonists. Until recently, AMs were the most commonly used drugs and included oxybutynin (IR, ER and tape), propiverine, tolterodine, trospium, darifenacin, solifenacin and fesoterodine. There is considerable evidence from basic and clinical studies that shows the efficacy of these AMs. Clinical studies have demonstrated their efficacy in relieving symptoms based on various symptom scores, bladder diaries, and urodynamic studies. Basic studies include those that investigated muscarinic subtype selectivity, pharmacokinetics (such as half-life, tissue selectivity, transferability into central nervous system, etc.) ( ). AMs have been reported to be effective not only for OAB, but also neurogenic bladder resulting from spinal cord injury or spina bifida by decreasing detrusor overactivity or low compliance bladder ( ). However, tolerability and adherence were low, probably due to side effects and/or lack of efficacy ( ). The most common side effects of AMs are dry mouth, constipation, and blurred vision. Recently, AMs have been reported to affect the central nervous system and may cause cognitive dysfunction.