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Area of Science:

  • Urology
  • Neurology
  • Pharmacology

Background:

  • Neurogenic lower urinary tract dysfunction (NLUTD) significantly impacts quality of life.
  • Treatment persistence is crucial for managing chronic conditions like NLUTD.
  • Mirabegron is a beta-3 adrenergic agonist used for overactive bladder symptoms.

Purpose of the Study:

  • To investigate factors influencing treatment persistence with mirabegron in adult patients with NLUTD.
  • To analyze discontinuation rates and reasons for mirabegron use in a real-world setting.

Main Methods:

  • Retrospective review of 110 adult patients diagnosed with NLUTD prescribed mirabegron.
  • Exclusion criteria included indwelling catheters and neurostimulators.
  • Data collected: demographics, neurological diagnosis, concomitant medications (anticholinergics, beta-blockers), treatment duration, and reasons for discontinuation.

Main Results:

  • Over half of patients (60/110) discontinued mirabegron within the study period.
  • Primary reasons for discontinuation were lack of efficacy (44/110) and side effects (10/110).
  • No significant differences in discontinuation were observed based on neurological disease, beta-blocker use, or anticholinergic burden.

Conclusions:

  • Mirabegron treatment persistence exceeds six months in over 50% of patients with NLUTD.
  • Identifying predictive factors for mirabegron persistence requires further investigation.
  • Lack of efficacy is a major driver for discontinuing mirabegron in NLUTD patients.