The comparative efficacy of drugs for the management of overactive bladder syndrome (OAB) remains undefined. A new indirect treatment comparison demonstrates similar efficacy of mirabegron versus several antimuscarinic drugs and onabotulinum toxin A in a number of outcome measures. Head-to-head trials of these agents are still required to optimize the management of patients with OAB.
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References
Obloza, A., Kirby, J., Yates, D. & Toozs-Hobson, P. Indirect treatment comparison (ITC) of medical therapies for an overactive bladder. Neurourol. Urodyn. http://dx.doi.org/10.1002/nau.23189 (2017).
Rossanese, M. et al. Critical analysis of phase II and III randomised control trials (RCTs) evaluating efficacy and tolerability of a β3-adrenoceptor agonist (Mirabegron) for overactive bladder (OAB). BJU Int. 115, 32–40 (2015).
Bucher, H. C., Guyatt, G. H., Griffith, L. E. & Walter, S. D. The results of direct and indirect treatment comparisons in meta-analysis of randomized controlled trials. J. Clin. Epidemiol. 50, 683–691 (1997).
Visco, A. G. et al. Anticholinergic therapy versus onabotulinumtoxina for urgency urinary incontinence. N. Engl. J. Med. 367, 1803–1813 (2012).
Herschorn, S. et al. The efficacy and safety of onabotulinumtoxinA or solifenacin compared with placebo in solifenacin-naive patients with refractory overactive bladder: results from a multicenter, randomized, double-blind, phase 3b trial. J. Urol. http://dx.doi.org/10.1016/j.juro.2017.01.069 (2017).
Wagg, A., Compion, G., Fahey, A. & Siddiqui, E. Persistence with prescribed antimuscarinic therapy for overactive bladder: a UK experience. BJU Int. 110, 1767–1774 (2012).
Chapple, C. R. et al. Persistence and adherence with mirabegron versus antimuscarinic agents in patients with overactive bladder: a retrospective observational study in UK clinical practice. Eur. Urol. http://dx.doi.org/10.1016/j.eururo.2017.01.037 (2017).
Chancellor, M. B. et al. Limitations of anticholinergic cycling in patients with overactive bladder (OAB) with urinary incontinence (UI): results from the CONsequences of Treatment Refractory Overactive bLadder (CONTROL) study. Int. Urol. Nephrol. 48, 1029–1036 (2016).
Drake, M. J. et al. Efficacy and safety of mirabegron add-on therapy to solifenacin in incontinent overactive bladder patients with an inadequate response to initial 4-week solifenacin monotherapy: a randomised double-blind multicentre phase 3B study (BESIDE). Eur. Urol. 70, 136–145 (2016).
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A.S. has received an unrestricted educational grant and has been an adviser for Allergan. A.S. has received payment for lectures on behalf of Allergan, Astellas and Pfizer. S.M. declares no competing interests.
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Sahai, A., Malde, S. The dilemma with comparing efficacy of OAB treatments. Nat Rev Urol 14, 393–394 (2017). https://doi.org/10.1038/nrurol.2017.67
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DOI: https://doi.org/10.1038/nrurol.2017.67