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Exploring the therapeutic potential of beta-3 adrenergic agonists in overactive bladder: A comprehensive review
Veena Nayak1, Sadhana N Holla1, Smita Shenoy2
1Associate Professor (Pharmacology), Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Abstract:
Overactive bladder (OAB) is characterized by urinary urgency, frequency, and incontinence. The primary medications used for OAB treatment include antimuscarinics and beta-3 adrenergic agonists. The objective of this review was to understand the beta-3 signaling mechanisms in OAB and analyze the results of studies comparing mirabegron either as monotherapy or in combination with antimuscarinics for OAB treatment. A literature search for comparison studies on beta-3 adrenergic drugs and antimuscarinic medications for OAB from different databases was conducted. Although the antimuscarinic class of medications has been reported to be an effective therapy for the symptomatic management of OAB, dose-limiting adverse effects continue to be the reason for discontinuation in the elderly population. Due to the high efficacy of mirabegron and the possible unavoidable side effects associated with antimuscarinic drugs, OAB can be treated with oral beta-3-agonists. In patients who are resistant to monotherapy, a combination therapy consisting of antimuscarinic agents and beta-3-agonists may be attempted. Primarily, this review emphasizes the role of beta-3 agonists in OAB in terms of their mechanism, safety, and efficacy in comparison with those of antimuscarinic drugs.
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