Patients with overactive bladder (OAB) prescribed mirabegron remain on treatment longer than those prescribed traditional antimuscarinics, British researchers reported in a paper published online ahead of print in European Urology.
In a retrospective, longitudinal, observational study looking at persistence and adherence to OAB pharmacotherapy among 21,996 eligible patients, Christopher R. Chapple, MD, of the Royal Hallamshire Hospital, Sheffield Teaching Hospitals, Sheffield, UK, and colleagues compared mirabegron with tolterodine ER, solifenacin, darifenacin, fesoterodine and other antimuscarinics over a 12-month period. In an unmatched analysis, the median time-to-discontinuation—the study’s primary endpoint—was significantly longer for mirabegron than tolterodine ER (169 vs 56 days) and other antimuscarinics (range 30–78 days). Compared with mirabegron use, tolterodine ER use was associated with a 1.55 times higher risk of treatment discontinuation in adjusted analyses. Use of other antimuscarinics was associated with 1.24 to 2.26 times increased risk.
“Mirabegron provides an alternative treatment option for OAB with the potential to increase treatment persistence,” Dr Chapple’s group concluded. “This is an important consideration for clinicians when managing chronic conditions, as well as for payers when considering the economic implications of available treatments for OAB.