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β3-Agonists for Overactive Bladder

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Abstract

Medical management of overactive bladder (OAB) has traditionally been with anticholinergic medications. While this drug class is effective for some patients, efficacy is not seen in all, and the side effect profile may result in decreased use. Mirabegron, a β3-adrenoceptor agonist, has been established as an alternative therapy. This chapter aims to review the history of mirabegron in addition to drug safety, efficacy, and reliability in a diverse group of patients including the elderly, those with cardiac comorbidities, and those with bladder outlet obstruction. Drug cost and comparison to anticholinergics and placebo is also addressed in this review. A growing body of evidence suggests that mirabegron is a safe and efficacious drug with a limited side effect profile rendering it as a potential first-line pharmacological option for the management of OAB.

Keywords

Overactive bladder Mirabegron β3-adrenoceptor agonist Antimuscarinics Anticholinergics Lower urinary tract symptoms Urinary retention Bladder outlet obstruction Urinary urgency Urinary frequency Urgency urinary incontinence Urodynamics 

Abbreviations

AE

Adverse effects

BID

Twice daily

BIM

Budget income model

BMI

Body mass index

BOO

Bladder outlet obstruction

BPM

Beats per minute

DBP

Diastolic blood pressure

HR

Heart rate

HRQOL

Health-related quality of life

HTN

Hypertension

LUTS

Lower urinary tract symptoms

NDO

Neurogenic detrusor overactivity

OAB

Overactive bladder

OAB-qSS

Overactive bladder questionnaire symptom score

PPBC

Patient perception of bladder control

PVR

Post-void residual

Qmax

Maximum flow

Qmaxpdet

Detrusor pressure at maximum flow

SBP

Systemic blood pressure

TEAE

Treatment emergent adverse effect

TS-VAS

Treatment satisfaction-visual analog scale

UDS

Urodynamics

UI

Urinary incontinence

UTI

Urinary tract infection

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Vanderbilt UniversityDepartment of Urologic SurgeryNashilleUSA

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