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Assessment of Codispensing Patterns of Mirabegron and Prespecified CYP2D6 Substrates in Patients with Overactive
Jingjun Wang1, Mary E Ritchey2, Kamika Reynolds2,3
1Sumitovant Biopharma, Inc, New York, NY, USA.
Drugs - Real World Outcomes
|May 23, 2023
Summary
Mirabegron, used for overactive bladder (OAB), is frequently dispensed with cytochrome P450 (CYP) 2D6 substrates, increasing the risk of drug interactions. Further research is needed to understand patient outcomes with concurrent use.
Area of Science:
- Pharmacology
- Clinical Pharmacy
- Drug Interactions
Background:
- Overactive bladder (OAB) symptoms include urinary urgency and incontinence.
- Mirabegron, a beta-3 adrenergic agonist for OAB, carries a warning for inhibiting cytochrome P450 (CYP) 2D6.
- This inhibition necessitates caution when co-administered with CYP2D6 substrates to prevent elevated substrate concentrations.
Purpose of the Study:
- To investigate the dispensing patterns of mirabegron alongside ten specific CYP2D6 substrates.
- To analyze the temporal relationship between mirabegron and CYP2D6 substrate dispensing in patients.
Main Methods:
- Retrospective analysis of the IQVIA PharMetrics® Plus Database.
- Inclusion of patients aged 18+ receiving CYP2D6 substrates before or during mirabegron use.
- Assessment of codispensing frequency and duration using descriptive statistics.
Main Results:
- Significant overlapping exposure periods were observed between mirabegron and ten CYP2D6 substrate cohorts.
- Median codispensing durations varied, with chronically administered substrates like metoprolol/carvedilol showing longer overlaps (75 days) than acutely administered ones like tramadol (15 days).
Conclusions:
- Dispensing patterns indicate frequent concurrent use of mirabegron with CYP2D6 substrates.
- Patients with OAB on mirabegron and CYP2D6 substrates face a heightened risk of drug-drug interactions.
- Further investigation into patient outcomes associated with these concurrent exposures is warranted.
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