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Efficacy of mirabegron for overactive bladder with human T cell lymphotropic virus-1 associated myelopathy
Tomohiro Matsuo1, Yasuyoshi Miyata1, Tatsufumi Nakamura2
1Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Objective:
Mirabegron is widely considered as an effective and safe drug for patients with overactive bladder (OAB). However, there is no evidence regarding the efficacy of mirabegron in human T cell lymphotropic virus-1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) patients with OAB symptoms. The aim of the present study was to clarify the efficacy of mirabegron in HAM/TSP patients with OAB symptoms.
Methods:
The present study evaluated the efficacy of mirabegron treatment (50 mg, once daily) in nineteen HAM/TSP patients with OAB symptoms by assessing subjective symptoms using the overactive bladder symptom score (OABSS) and International Prostate Symptom Score (IPSS) before and 12 weeks after administration. Voided volume (VV), maximum flow rate (Qmax ), and post-void residual (PVR) urine volume were evaluated as objective symptoms.
Results:
Mirabegron treatment improved OABSS in terms of night-time frequency, urgency, and total score (P < .001). In addition, on the IPSS, mirabegron therapy improved urgency, nocturia, storage symptoms (Questions 2, 4 and 7 on the IPSS), as well as the total score (P < .001). The quality of life (QoL) on the IPSS also improved after treatment (P < .001). However, there were no significant changes in objective symptoms, as measured by VV, Qmax , and PVR, after treatment. One patient (5.3%) complained of dry mouth; because this adverse effect was very mild, the patient did not discontinue mirabegron.
Conclusions:
Mirabegron administration improved subjective symptoms in HAM/TSP patients with neurogenic OAB.
Insights
Mirabegron effectively improved overactive bladder (OAB) symptoms in patients with human T cell lymphotropic virus-1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP). The treatment enhanced subjective OABSS and IPSS scores, improving quality of life without significant changes in objective urinary flow metrics.
Area of Science:
- Neurology
- Urology
- Pharmacology
Background:
- Overactive bladder (OAB) is a common condition.
- Human T cell lymphotropic virus-1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) can cause neurogenic OAB.
- Efficacy of mirabegron in HAM/TSP patients with OAB was previously unestablished.
Purpose of the Study:
- To evaluate the efficacy of mirabegron in treating OAB symptoms in patients with HAM/TSP.
- To assess changes in subjective and objective urinary symptoms after mirabegron treatment.
Main Methods:
- Nineteen HAM/TSP patients with OAB symptoms received mirabegron 50 mg once daily for 12 weeks.
- Subjective symptoms were assessed using the Overactive Bladder Symptom Score (OABSS) and International Prostate Symptom Score (IPSS).
- Objective parameters including voided volume (VV), maximum flow rate (Qmax), and post-void residual (PVR) urine volume were measured.
Main Results:
- Mirabegron significantly improved OABSS and IPSS scores, including reductions in night-time frequency, urgency, and overall symptom burden.
- Patient-reported quality of life (QoL) also showed significant improvement.
- No significant changes were observed in objective measures like VV, Qmax, or PVR.
- Dry mouth was a mild, infrequent adverse effect, with one patient experiencing it.
Conclusions:
- Mirabegron is effective in improving subjective neurogenic OAB symptoms in patients with HAM/TSP.
- The drug demonstrates a favorable safety profile in this patient population.
- Further research may explore objective symptom improvements with longer treatment durations or different dosages.
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