Abstract
Background and Objective: Over the past few years, mirabegron has been increasingly used as a therapeutic option for neurogenic lower urinary tract dysfunction. Here, we carried out a meta-analysis to investigate the efficacy and safety of mirabegron for the treatment of neurogenic lower urinary tract dysfunction. Methods: We used a range of databases to retrieve randomized controlled trials (RCTs) relating to mirabegron in patients with neurogenic lower urinary tract dysfunction: PubMed, Embase, and Cochrane Library; our strategy conformed to the PICOS (populations, interventions, comparators, outcomes, and study designs) strategy. Results: Our analyses involved four RCTs involving 245 patients. We found that mirabegron treatment resulted in a significant improvement in bladder compliance [mean difference (MD) = 19.53, 95% confidence interval (CI): 14.19 to 24.87, P < 0.00001], urinary incontinence episodes (MD = −0.78, 95% CI: −0.89 to −0.67, P < 0.00001) and Incontinence Quality of Life (I-QOL) (MD = 8.02, 95% CI: 3.20 to 12.84, P = 0.001). Significant differences were detected in terms of Patient Perception of Bladder Condition (PPBC) (MD = −0.54, 95% CI: −1.46 to 0.39, P = 0.26) and urinary urgency episodes (MD = −0.72, 95% CI: −3.1 to 1.66, P = 0.55). With regard to safety, there were no significant differences between mirabegron and control groups in terms of the incidence of drug-related adverse events [odds ratio (OR): 0.83, 95% CI: 0.43 to 1.59, P = 0.57], arrhythmias (OR: 1.27, 95% CI: 0.37 to 4.38, P = 0.70), hypertension (OR: 0.70, 95% CI: 0.13 to 3.82, P = 0.68), or post-voiding residual volume (MD: 1.62, 95% CI: −9.00 to 12.24, P = 0.77). Conclusion: Mirabegron is an efficacious and safe treatment for patients with neurogenic lower urinary tract dysfunction.
Highlights
Patients suffering from spinal cord injury (SCI) and neurological disorders (e.g., multiple sclerosis (MS) and Parkinson’s disease) often present with neurogenic lower urinary tract dysfunction (NLUTD) (Stöhrer et al, 2009; Harris and Lemack, 2016)
We found that mirabegron treatment resulted in a significant improvement in bladder compliance [mean difference (MD) 19.53, 95% confidence interval (CI): 14.19 to 24.87, P < 0.00001], urinary incontinence episodes (MD −0.78, 95% CI: −0.89 to −0.67, P < 0.00001) and Incontinence Quality of Life (I-QOL) (MD 8.02, 95% CI: 3.20 to 12.84, P 0.001)
Significant differences were detected in terms of Patient Perception of Bladder Condition (PPBC) (MD −0.54, 95% CI: −1.46 to 0.39, P 0.26) and urinary urgency episodes (MD −0.72, 95% CI: −3.1 to 1.66, P 0.55)
Summary
Patients suffering from spinal cord injury (SCI) and neurological disorders (e.g., multiple sclerosis (MS) and Parkinson’s disease) often present with neurogenic lower urinary tract dysfunction (NLUTD) (Stöhrer et al, 2009; Harris and Lemack, 2016). Patients with severe NLUTD can develop renal failure and complicated urinary tract infections and may even die. Anticholinergic (antimuscarinic) drugs are recommended as the first-line treatment for NLUTD. Over the past few years, mirabegron has been increasingly used as a therapeutic option for neurogenic lower urinary tract dysfunction. We carried out a meta-analysis to investigate the efficacy and safety of mirabegron for the treatment of neurogenic lower urinary tract dysfunction
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