LBA01-03 COMPARISON OF MIRABEGRON, SOLIFENACIN AND TAMSULOSIN FOR STENT RELATED SYMPTOMS: A DOUBLE BLINDED RANDOMIZED CONTROL TRIAL

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You have accessJournal of UrologyLate-Breaking Abstracts (LBA1)1 Apr 2020LBA01-03 COMPARISON OF MIRABEGRON, SOLIFENACIN AND TAMSULOSIN FOR STENT RELATED SYMPTOMS: A DOUBLE BLINDED RANDOMIZED CONTROL TRIAL Abhishek Chandna*, Santosh Kumar, Uttam Kumar Mete, Sudheer Kumar Devana, Aditya Prakash Sharma, and Samir Malhotra Abhishek Chandna*Abhishek Chandna* More articles by this author , Santosh KumarSantosh Kumar More articles by this author , Uttam Kumar MeteUttam Kumar Mete More articles by this author , Sudheer Kumar DevanaSudheer Kumar Devana More articles by this author , Aditya Prakash SharmaAditya Prakash Sharma More articles by this author , and Samir MalhotraSamir Malhotra More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000946.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Introduction: Ureteral double J (DJ) stents are associated with stent related symptoms (SRSs) in up to 80% patients. Alpha blockers and anti-cholinergics have demonstrated efficacy in ameliorating SRSs. Mirabegron, a novel beta-3 receptor antagonist, demonstrated benefit in overactive bladder, with beta-3 receptors found in the ureter as well. We conducted a double blinded randomized control trial (MIRASOTA; CTRI/2019/02/017808) to evaluate the efficacy of mirabegron in ameliorating SRSs as compared to solifenacin or tamsulosin. Methods: Between October 2018 and December 2019, 150 patients undergoing DJ stent placement following ureteroscopic stone removal (URS), percutaneous nephrolithotomy (PCNL) or lap/robotic pyeloplasty were randomized in a 1:1:1 fashion into 3 groups. Patients in groups A, B and C received mirabegron 50 mg, solifenacin 5mg and tamsulosin 0.4mg once a day respectively. Stent was removed 4 weeks after surgery. Patients were followed at POD10 (I visit), 4 weeks (II visit) post surgery and 2 weeks post-stent removal. Validated vernacular version of ureteral stent symptoms questionnaire (USSQ) was evaluated at each visit. Results: Out of the 150 patients randomized, 124 patients (A; n = 42, B; n = 40 and C; n = 42) completed the study. Two patients in group C withdrew from the study due to side effects. Protocol violation was the most common reason for exclusion. Baseline demographic variables were comparable across groups. The groups were comparable in terms of urinary index score of USSQ at I and II visits (p = 0.111 and 0.084, respectively). No significant difference was observed between the groups in terms of pain index (p = 0.054 and 0.409, respectively). However, a significantly lower proportion of patients in group B persisted to have bodily pain at II visit (p = 0.035). Patients in group A demonstrated significantly better general health index scores at I visit (p = 0.021), which were not replicated at II visit (p = 0.684). No significant differences were observed in terms of sexual score or work performance. Constipation and dry mouth were noted in 14.7% patients in group B whereas headache (7.1%) was the most common side effect in group A. There was no significant association between drug group and type of surgery. Conclusions: Mirabegron has shown comparable benefit in alleviating SRSs and may be beneficial in cases where tamsulosin or solifenacin are contra-indicated or poorly tolerated. The MIRASOTA trial is first and only double blinded RCT comparing mirabegron with tamsulosin or solifenacin for SRSs. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1020-e1020 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Abhishek Chandna* More articles by this author Santosh Kumar More articles by this author Uttam Kumar Mete More articles by this author Sudheer Kumar Devana More articles by this author Aditya Prakash Sharma More articles by this author Samir Malhotra More articles by this author Expand All Advertisement PDF downloadLoading ...