FEMALES over the age of 80 with overactive bladder (OAB) may benefit from mirabegron monotherapy, suggest the results of a retrospective analysis. The research team, led by Cihat Özcan, Department of Urology, Health Sciences University, Gülhane Training and Research Hospital, Ankara, Türkiye, aimed to evaluate the efficacy and safety of mirabegron monotherapy in elderly patients who were discontinued anticholinergic drugs, the main pharmacological management for OAB.
The retrospective analysis included 42 female patients with uncomplicated OAB symptoms, presence of symptoms for at least 3 months, and prior use of at least one anticholinergic drug that was subsequently discontinued by a non-urology department. All patients completed an OAB-V8 form before and after treatment to assess symptoms, and patients subsequently received single-agent mirabegron at 50 mg per day for 12 weeks or longer following discontinuation of previous treatment. The median patient age, median number of comorbid conditions, and the median symptom score taken from the OAB-V8 form was 86, 4, and 19, respectively.
Analysis following mirabegron treatment showed a statistically significant improvement in symptom scores, decreasing from 19 to 10 (P=0.023). Further analysis showed that urgency, frequency, and nocturia scores were all significantly lower (P <0.05 for all comparisons). Furthermore, analysis regarding the safety of mirabegron showed that was no significant difference in systolic (P=0.32) and diastolic (P=0.11) blood pressure or heart rate (P=0.48) when compared to baseline measurements. Adverse events reported were dry mouth (n=2), constipation (n=2), headache (n=1), dyspepsia (n=2), nasal congestion (n=1), dizziness (n=1), and nausea (n=1).
The authors acknowledged that due to the retrospective nature of the study, small sample size, and short follow-up time, further prospective, randomised trials with larger sample sizes would be required to achieve a better understanding. However, Özcan and team summarised: “Mirabegron is an effective and safe therapy in very older (>80 years) women with OAB. We recommend mirabegron monotherapy as an alternative medical treatment choice for the management of OAB.”.
