Title: Mirabegron as a New Class of Oral Drug for Overactive Bladder Syndrome: Many Positive Perspectives, Some Concerns
Abstract: Overactive bladder (OAB) syndrome is a highly prevalent condition characterized by the presence of urgency with or without incontinence, frequency, and nocturia. Epidemiologic data suggest that OAB is present in about 12% of all adult men and women, although prevalence rates increase with aging in both sexes [1]. Antimuscarinic receptors antagonists (ie, darifenacin, fesoterodine, oxybutynin, solifenacin, tolterodine, and trospium) are the standard first-line drug therapy for OAB. Antimuscarinics act by competitively inhibiting the effects of acetylcholine at postjunctional muscarinic M3 receptors on detrusor muscle cells. It has been suggested they may reduce detrusor activity and improve bladder capacity via additional mechanisms including direct inhibition of bladder afferent signaling at the level of the urothelium and suburothelium where acetylcholine receptors have been demonstrated on urothelium, suburothelial interstitial cells, and afferent nerves [2]. Antimuscarinic drugs are quite effective in improving urgency episodes, number of micturitions, and number of urgency incontinence episodes per 24 h both in idiopathic and neurogenic OAB [3,4]. However, many patients do not get sufficient relief from symptoms or they experience intolerable adverse events (AEs), with dry mouth and constipation usually among the most bothersome. The strategy for treatment of those patients who are unresponsive and/or intolerant to antimuscarinic drugs is currently not well standardized, but detrusor injections of onabotulinumtoxinA or abobotulinumtoxinA are often used with good results [5]. In the present issue of European Urology, two very relevant randomized controlled trials (RCTs) onmirabegron
Publication Year: 2012
Publication Date: 2012-11-16
Language: en
Type: letter
Indexed In: ['crossref', 'pubmed']
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Cited By Count: 15
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