Reply

Abstract

Listen

Translate article

This was a good editorial comment and we thank the editors for the appreciation of the positive outcome with mirabegron in patients with the overactive bladder syndrome (OAB). Indeed we are enthusiastic about the efficacy and limited side effects of this first drug of a new pharmacologic class approved by the Food and Drug Administration and available for the treatment of patients with symptoms of OAB. We see mirabegron as a welcome additional therapeutic modality for patients with OAB that does not show sufficient clinical efficacy with other forms of pharmacologic treatment. However, according to the efficacy results and the limited side effects, we also consider mirabegron as a first choice option for any patient with OAB who needs pharmacologic manipulation. An important question that still has to be addressed is whether we can further increase the clinical efficacy of pharmacologic treatment for OAB with a combination of mirabegron and an antimuscarinic drug. We hope that these pharmacologic developments shall also increase adherence to treatment by providing increased global clinical efficacy, thus eliminating or further delaying the need for minimally invasive treatment modalities, such as botulinum toxin injections and neuromodulation. Editorial CommentUrologyVol. 82Issue 2PreviewPharmacologic treatment of symptoms of overactive bladder (OAB) has been based on antimuscarinic treatment for over 30 years. Clinical research has shown significant improvement of patient symptoms and quality of life with a dry rate (on a 3-day voiding diary) of approximately 50% in patients with urgency incontinence.1 Evidence from real-life practice tampered the initial enthusiasm showing a low adherence to the prescribed regimen, with most patients discontinuing treatment within a year because of lack of efficacy and side effects. Full-Text PDF