Mirabegron in patients with Parkinson disease and overactive bladder symptoms: A retrospective cohort

This study aimed to assess the outcomes of mirabegron for the treatment of overactive bladder (OAB) symptoms in patients with Parkinson disease (PD).

A retrospective study was conducted including patients with PD who received mirabegron 50 mg once daily for OAB symptoms between 2012 and 2017. The primary endpoint was clinical success defined as any improvement in overactive bladder symptoms self-assessed by the patients 6 weeks after mirabegron initiation. Secondary endpoints included number of pads per day, number of nocturia episodes and adverse events.

Fifty patients (mean 74 years old) were included. Before being treated with mirabegron, 56% had failed prior anticholinergic therapy. After 6 weeks of mirabegron 50 mg, five patients (11.4%) had a complete resolution of their OAB symptoms; 25 patients (50%) reported improvement, 23 (46%) reported no change and 2(4%) reported worsening of their OAB symptoms. The number of pads per day decreased from 1.5 to 0.9 (p = 0.01) and so did the number of nocturia episodes (from 3 to 2.6/night; p = 0.02). Only 2 adverse events were reported during mirabegron treatment (4%): one dizziness and one diaphoresis, that disappeared after mirabegron discontinuation. After a median follow-up of 19 months, 23 patients (46%) persisted on mirabegron. Persistence rates were 51.5%, 44.6% and 36.4% at 1, 2 and 3 years respectively.

Mirabegron has an excellent safety profile and appears to be an effective treatment for overactive bladder symptoms in patients with PD. Further prospective randomized trials are needed to properly assess mirabegron in PD patients.

Parkinsonism & related disorders. 2018 Jul 20 [Epub ahead of print]

Benoit Peyronnet, Gregory Vurture, Jose-Alberto Palma, Dominique R Malacarne, Andrew Feigin, Rachael D Sussman, Milton C Biagioni, Ricardo Palmerola, Rebecca Gilbert, Nirit Rosenblum, Steven Frucht, Horacio Kaufmann, Victor W Nitti, Benjamin M Brucker

Department of Urology, New York University School of Medicine, New York, USA; Department of Urology, University of Rennes, Rennes, France. Electronic address: ., Department of Urology, New York University School of Medicine, New York, USA., Department of Neurology Dysautonomia Center, New York University School of Medicine, New York, USA., The Marlene & Paolo Fresco Institute for Parkinson's & Movement Disorders, New York University School of Medicine, New York, USA.