Efficacy of Mirabegron Compared with Tolterodine, Placebo, and Different Doses of Mirabegron on OAB Patient Evaluated in 4 Weeks Period: A Meta-Analysis

Introduction: Mirabegron is one of the therapeutic options in overactive bladder where its efficacy and safety are better than antimuscarinics in several existing studies. Tolerability, treatment duration, and cost are often the deciding points for patient adherence and compliance in taking treatments. Many patients and doctors expect fast and visible results with relatively short treatments duration. This meta-analysis study describes and compares the efficacy of mirabegron compared with antimuscarinic, placebo or different doses of mirabegron over 4 weeks’ treatment range.

Methods: A literature search was performed using the Cochrane Library, Pubmed, and 5 other journal database. The literature reviewed included randomized and nonrandomized prospective and clinical trial studies. Mean difference (MD) was used to assess micturition frequency, incontinence episode, mean volume voided, nocturia episodes, urgency episodes, urgency incontinence episodes, and level of urgency of patients recorded within 4 weeks treatment duration. We used the Cochrane Collaboration’s Review Manager 5.4.1 software for statistical analysis

Results: Six publications that met eligibility criteria was included in this study. Meta-analysis of extractable data showed that Mirabegron was found significantly more efficacious than placebo for majority of efficacy endpoints recorded within 4 weeks’ treatment duration. In contrast, the comparison of mirabegron with tolterodine 4 mg showed no significant difference in outcome across all seven assessment criteria. On the other hand, mirabegron was also found to be more efficacious when administered in higher doses compared to lower doses at the majority efficacy endpoint

Conclusion: Withtin 4-week treatment duration, Mirabegron can provide significant results compared to placebo. However, the results are still not much different from tolterodine. Higher doses of mirabegron also provide a better result when compared with lower doses. The lowest dose with statistically significant results compared to placebo was obtained from mirabegron 25 mg.