COMPARATIVE EFFECTS OF MIRABEGRON AND SOLIFENACIN COMBINATION VERSUS MIRABEGRON MONOTHERAPY FOR OVERACTIVE BLADDER IN WOMEN
Main Article Content
Keywords
Overactive Bladder, Solifenacin, Mirabegron
Abstract
Introduction: Management of Overactive bladder (OAB) continues to present significant challenges. Mirabegron, β3 adrenergic agonist recent approval has captured much attention in specialists, of course, who care for patients with OAB. Most Clinicians prefer antimuscarinic agent as first line therapy for the OAB patients which can be titrated to a higher dose or may be switched to another parasympatholytic or mirabegron. It has been proven by studies that mirabegron added to antimuscarinic therapy enhances treatment efficacy without a loss in tolerability and, with that, improves long-term adherence.
Objectives: To evaluate and compare the effectiveness of combination therapy of mirabegron and solifenacin with the monotherapy of mirabegron for the treatment of overactive Bladder (OAB) in women.
Material and Method: 480 women with diagnosis of overactive bladder (OAB) with age range of 20 to 50 years were included in the study. Patients with urinary tract infections, bladder stones, pelvic malignancies, spinal injuries, multiple sclerosis, diabetic neuropathy and Parkinson’s disease were excluded from the study. The patients were divided into 2 groups. Patients in Group A received mirabegron 25 mg once daily and solifenacin 5 mg once daily for 12 weeks. For the same duration of 12 weeks, patients allocated to Group B received only mirabegron 25 mg once daily. Urinary incontinence was monitored at both pre-treatment and after a treatment duration of 12 weeks by the patient history. OABS score baseline and after 12 weeks was also taken. Cases were followed for 12 weeks through contact numbers with assessment of efficacy of intervention at the end of follow-up based on the said operational definition.
Results: The mean Overactive Bladder Symptom (OABS) score in Group A (mirabegron + solifenacin) was 10.33 ± 3.12 at baseline and was improved to 4.43 ± 1.32 after 12 weeks while in Group B (mirabegron alone), it was 10.13 ± 2.98 at baseline and decreased to 6.87 ± 2.76 after 12 weeks. The efficacy of the combination therapy in Group A was observed in 143 patients (59.58%), compared to 117 patients (48.75%) in Group B, with a p-value of 0.017 which is statistically significant.
Conclusion: Results of this study established that combination therapy of mirabegron and solifenacin was found to be more effective in treating overactive bladder in women than the monotherapy of mirabegron.
References
2. Hsu, F. C., Weeks, C. E., Selph, S. S., Blazina, I., Holmes, R. S., & McDonagh, M. S. (2019). Updating the evidence on drugs to treat overactive bladder: a systematic review. International Urogynecology Journal, 30(10), 1603–1617. https://doi.org/10.1007/s00192-019-04022-8
3. Jamil, M. N., Irum, S., & Islam, E. U. (2023). Comparison Of Solifenacin And Mirabegron For The Treatment Of Overactive Bladder. Journal of Ayub Medical College, Abbottabad : JAMC, 35(2), 298–300. https://doi.org/10.55519/JAMC-02-11795
4. Kumar, S., Tiwari, V., Chaurasia, D. K., Kumar, S., & Mishra, S. (2023). A Comparative Study of Solifenacin, Mirabegron, and Their Combination as Bladder Relaxants in the Management of Overactive Bladder. Cureus, 15(9). https://doi.org/10.7759/cureus.45612
5. Kuo, Y. C., & Kuo, H. C. (2023). Comparative study of different combinations of mirabegron and antimuscarinics in treatment for overactive bladder syndrome in elderly patients. Tzu Chi Medical Journal, 35(1), 62–68. https://doi.org/10.4103/tcmj.tcmj_209_21
6. Mahapatra, S. K., Dash, R. R., Rath, B., & Hota, P. S. (2022). Solifenacin and Mirabegron Monotherapies Versus Combination Therapy in Overactive Bladder: A Prospective Observational Study. Biomedical and Pharmacology Journal, 15(1), 491–497. https://doi.org/10.13005/bpj/2389
7. Majd, Z. K., Mohammadnezhad, G., Taheri, S., & Yousefi, N. (2023). Cost-Utility Analysis of Mirabegron Compared to Solifenacin in the Treatment of Overactive Bladder (OAB) in Iran. Iranian Journal of Pharmaceutical Research, 22(1), 1–10. https://doi.org/10.5812/ijpr-136447
8. Makhani, A., Thake, M., & Gibson, W. (2020). Mirabegron in the treatment of overactive bladder: Safety and efficacy in the very elderly patient. Clinical Interventions in Aging, 15, 575–581. https://doi.org/10.2147/CIA.S174402
9. Mueller, E. R., van Maanen, R., Chapple, C., Abrams, P., Herschorn, S., Robinson, D., Stoelzel, M., Yoon, S. J., Al-Shukri, S., Rechberger, T., & Gratzke, C. (2019). Long-term treatment of older patients with overactive bladder using a combination of mirabegron and solifenacin: a prespecified analysis from the randomized, phase III SYNERGY II study. Neurourology and Urodynamics, 38(2), 779–792. https://doi.org/10.1002/nau.23919
10. O’kane, M., Robinson, D., Cardozo, L., Wagg, A., & Abrams, P. (2022). Mirabegron in the Management of Overactive Bladder Syndrome. International Journal of Women’s Health, 14, 1337–1350. https://doi.org/10.2147/IJWH.S372597
11. Özkidik, M., Coşkun, A., Asutay, M. K., Bahçeci, T., & Hamidi, N. (2019). Efficacy and tolerability of mirabegron in female patients with overactive bladder symptoms after surgical treatment for stress urinary incontinence. International Braz J Urol, 45(4), 782–789. https://doi.org/10.1590/S1677-5538.IBJU.2018.0518
12. Raj, M. O., Jose, J., Paul, F., Sreedharan, S., & Uthaman, N. (2024). Therapeutic effectiveness and adverse drug reactions of mirabegron versus solifenacin in the treatment of overactive bladder syndrome. Perspectives in Clinical Research, 15(3), 147–151. https://doi.org/10.4103/picr.picr_166_23
13. Salem, A. A. M., Kamhawy, O. M., Salem, E. A. E., & Elsayed, I. I. (2020). Mirabegrone versus solifenacine in treatment of overactive bladder in female patients in zagazig university hospitals. Egyptian Journal of Hospital Medicine, 81(5), 2078–2083. https://doi.org/10.21608/EJHM.2020.126406
14. Tang, Q. lai, Zhou, S., Liu, Y. qing, Wu, J., & Tao, R. zhen. (2022). Efficacy and safety of combination of mirabegron and solifenacin in patients with double-J stent related overactive bladder: a prospective study. Scientific Reports, 12(1), 1–7. https://doi.org/10.1038/s41598-022-23795-5
15. Wang, J., Zhou, Z., Cui, Y., Li, Y., Yuan, H., Gao, Z., Zhu, Z., & Wu, J. (2019). Meta-analysis of the efficacy and safety of mirabegron and solifenacin monotherapy for overactive bladder. Neurourology and Urodynamics, 38(1), 22–30. https://doi.org/10.1002/nau.23863
16. Warudkar, S., Jain, A. B., Dave, N. S., & Chaturvedi, A. R. (2022). Meta-analysis of efficacy and safety of Mirabegron plus Solifenacin combination therapy in comparison with Solifenacin monotherapy in overactive bladder. European Urology, 81(4), S662–S663. https://doi.org/10.1016/s0302-2838(22)00526-7
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Mudassar Saeed Pansota
MBBS, MS (Urology), Assistant Professor, Department of Urology, Shahida Islam Medical & Dental College, Lodhran, Pakistan
Farheen Hameed
Associate Professor, MBBS, MPhil (Pharmacology), Department of Pharmacology, Shahida Islam Medical & Dental College, Lodhran, Pakistan
Sama Ul Haque
MBBS, MPhil (Anatomy), Associate Professor, Anatomy, Fazaia Ruth Pfau Medical College, Karachi, Pakistan
Muhammad Ali Zubair
MBBS, MPhil (Pharmacology), Assistant Professor, Department of Pharmacology, Shahida Islam Medical and Dental College, Lodhran, Pakistan
Shazia Begum Shahani
MBBS, MPhil (Anatomy), Professor, Department of Anatomy, Liaquat University of Medical & Health Science, Jamshoro, Pakistan
Mujeeb-Ur-Rehman Sahito
MBBS, MS (General Surgery), MS (Urology), MPhil (Anatomy), Associate Professor, Department of Anatomy, Peoples’ University of Medical & Health Sciences for Women, Shaheed Benazirabad, Pakistan