In clinical studies, mirabegron has been shown to cause a small increase in heart rate with a slight increase in QTc interval, as indicated on electrocardiograms. The mechanisms of these effects are unclear. The findings of a recent study might provide some new clues, although, the relevance of these new observations to the treatment of patients with overactive bladder syndrome have yet to be established.
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References
Brodde, O. E., Bruck, H. & Leineweber, K. Cardiac adrenoceptors: physiological and pathophysiological relevance. J. Pharmacol. Sci. 100, 323–337 (2006).
Skeberdis, V. A. et al. β3-adrenergic receptor activation increases human atrial tissue contractility and stimulates the L-type Ca2+ current. J. Clin. Invest. 118, 3219–3227 (2008).
Christ, T. et al. Human atrial β1L-adrenoceptor but not β1L-adrenoceptor activation increases force and Ca2+ current at physiological temperature. Br. J. Pharmacol. 162, 823–839 (2011).
Mo, W. et al. The β3-adrenoceptor agonist mirabegron increases human atrial force through β1-adrenoceptors: an indirect mechanism? Br. J. Pharmacol. http://dx.doi.org/10.1111/bph.13897 (2017).
Korstanje, C. et al. Translational science approach for assessment of cardiovascular effects and proarrhythmogenic potential of the beta-3 adrenergic agonist mirabegron. J. Pharmacol. Toxicol. Methods http://dx.doi.org/10.1016/j.vascn.2017.04.008 (2017).
Rosa, G. M. et al. Cardiovascular safety of β3-adrenoceptor agonists for the treatment of patients with overactive bladder syndrome. Eur. Urol. 69, 311–323 (2016).
Andersson, K. E. et al. Cardiovascular morbidity, heart rates and use of antimuscarinics in patients with overactive bladder. BJU Int. 106, 268–274 (2010).
Balachandran, A. A. & Duckett, J. R. The risk and severity of developing symptomatic palpitations when prescribed mirabegron for overactive bladder. Eur. J. Obstet. Gynecol. Reprod. Biol. 187, 60–63 (2015).
Krauwinkel, W. et al. Pharmacokinetic properties of mirabegron, a β3-adrenoceptor agonist: results from two phase I, randomized, multiple-dose studies in healthy young and elderly men and women. Clin. Ther. 34, 2144–2160 (2012).
Malik, M. et al. Proarrhythmic safety of repeat doses of mirabegron in healthy subjects: a randomized, double-blind, placebo-, and active-controlled thorough QT study. Clin. Pharmacol. Ther. 92, 696–706 (2012).
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K-E.A. declares that he is a consultant and/or on the advisory board for Allergan, Astellas and Ferring.
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Andersson, KE. Cardiovascular effects of mirabegron. Nat Rev Urol 14, 587–588 (2017). https://doi.org/10.1038/nrurol.2017.113
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DOI: https://doi.org/10.1038/nrurol.2017.113
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