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Efficacy and tolerability of mirabegron compared with solifenacin for children with idiopathic overactive bladder: A
Seong Cheol Kim1, Myungchan Park1, Chongsok Chae1
1Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Insights
Mirabegron and solifenacin show similar effectiveness for treating pediatric idiopathic overactive bladder (OAB). Mirabegron is a safe alternative with few side effects in children with OAB.
Area of Science:
- Pediatric Urology
- Pharmacology
- Clinical Medicine
Background:
- Idiopathic overactive bladder (OAB) significantly impacts children's quality of life.
- Current treatment options for pediatric OAB include anticholinergic medications like solifenacin.
- Mirabegron, a beta-3 adrenergic agonist, offers a different mechanism of action for OAB treatment.
Purpose of the Study:
- To compare the efficacy and tolerability of mirabegron versus solifenacin in pediatric patients diagnosed with idiopathic OAB.
- To identify predictive factors for symptom improvement in children treated for OAB.
Main Methods:
- Retrospective review of 45 pediatric patients (5-15 years) with idiopathic OAB treated with either solifenacin or mirabegron.
- Efficacy assessed via patient reports and frequency-volume charts; response defined as ≥90% symptom reduction.
- Tolerability evaluated by documenting drug-induced adverse effects.
Main Results:
- Both mirabegron and solifenacin significantly improved age-adjusted bladder capacity ratio (p<0.002 for both).
- No significant difference in efficacy was observed between mirabegron and solifenacin.
- Lower baseline bladder capacity was associated with a positive treatment response (OR, 7.41; p=0.044).
- Adverse events were infrequent, reported in only 10.3% of solifenacin-treated patients.
Conclusions:
- Mirabegron demonstrates comparable efficacy to solifenacin for treating pediatric idiopathic OAB.
- Mirabegron presents a safe alternative treatment option for pediatric OAB due to its favorable tolerability profile.
Purpose:
To compare the efficacy and tolerability of mirabegron and solifenacin in pediatric patients with idiopathic overactive bladder (OAB) and to identify factors affecting OAB symptom improvement after treatment.
Materials And Methods:
We retrospectively reviewed 103 patients (5-15 years old) who visited our hospital with OAB symptoms between July 2017 and March 2019. All participants had received solifenacin or mirabegron. Those who had secondary OAB or who did not complete the frequency-volume chart either before or after treatment were excluded. The age-adjusted bladder capacity ratio was used to evaluate bladder capacity. Efficacy was assessed on the basis of patient reports and changes in the frequency-volume chart, and ≥90% reduction was regarded as "responding to medication." Tolerability was assessed by obtaining reports from patients about the adverse effects of the drug.
Results:
After the exclusion of 58 patients, 45 patients (29 in solifenacin-group and 16 in mirabegron-group) were included in the primary analysis. The age-adjusted bladder capacity ratio increased from 0.71 to 0.96 (p<0.001) and from 0.57 to 0.97 (p=0.002) after solifenacin and mirabegron use, respectively. Decreased bladder capacity before medication was associated with responding to medication (odds ratio, 7.41; p=0.044). There was no significant difference in efficacy between the two drugs. Drug-induced adverse effects were reported in only 3 (10.3%) of the solifenacin-treated patients.
Conclusions:
Mirabegron showed comparable efficacy to solifenacin in pediatric patients with idiopathic OAB. Additionally, only few adverse effects were reported, suggesting that mirabegron can be a safe alternative for the treatment of idiopathic pediatric OAB.
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