AI Article Synopsis
- The study is a systematic review assessing the safety and effectiveness of mirabegron for treating neurogenic detrusor overactivity in patients with spinal cord injury (SCI) or multiple sclerosis (MS).
- A total of 488 patients from 11 studies were analyzed, showing that while mirabegron is often used as a second-line treatment after anticholinergics, its efficacy is comparable to anticholinergics in MS patients but not strong enough for SCI patients based on urodynamic parameters.
- Although mirabegron has a generally good safety profile, there are mild cardiovascular risks, including reports of tachyarrhythmia and tachycardia in a few patients.
Article Abstract
Study Design: Systematic review.
Objective: To evaluate the efficacy and safety of mirabegron in patients with neurogenic detrusor overactivity due to SCI or MS.
Methods: A comprehensive search of the Pubmed, Cochrane, Scopus, and Embase databases was performed. Studies evaluating adult patients with neurogenic detrusor overactivity due to SCI or MS were analyzed according to clinical and urodynamic outcome parameters.
Results: A total of 488 patients were included in 11 studies, with sample sizes ranging from 15 to 91. The duration of the treatments varied from 4 weeks to 12 months. Mirabegron was used as a secondline treatment after anticholinergics in most of the studies. While clinical outcome parameters are used in studies involving only MS patients, urodynamic outcome parameters are also used in studies involving patients with SCI. The efficacy of mirabegron was found not to be different than anticholinergics when compared in MS patients. Comprehensive urodynamic evaluation was performed in 2 randomized, double-blind, placebo-controlled studies and no satisfactory results were obtained compared to placebo. In retrospective studies there were some significant improvements in P, MCC and compliance. The major safety concern with mirabegron is cardiovascular safety. In one study, tachyarrhythmia and palpitations reported in a patient with SCI at C6 level, in another study tachycardia reported in one patient with MS.
Conclusions: Although mirabegron demonstrates similar clinical efficacy to anticholinergics in MS patients, its effect on urodynamic parameters in patients with SCI cannot be considered satisfactory. It has a good safety profile with mild cardiovascular side effects.
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| http://dx.doi.org/10.1038/s41393-022-00853-3 | DOI Listing |
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