Does metabolic syndrome influence the efficacy of mirabegron treatment in female patients with overactive bladder?

We aimed to determine whether the presence of metabolic syndrome (MS) affects the efficacy of mirabegron in treatment-naïve women with overactive bladder (OAB).

Women being treated with mirabegron 50 mg were allocated to MS and non-MS groups, and the efficacy of treatment of OAB was compared using the OAB symptom score (OABSS) and a 3-day voiding diary before and 12 weeks after starting treatment. The Wilcoxon signed-rank and Mann-Whitney U tests and multivariate logistic regression were used for statistical analyses, and a p-value < 0.05 was considered to represent statistical significance.

Of the 197 patients who completed the trial, 43 (23.9%) had MS. After 12 weeks of mirabegron treatment, both the MS and non-MS groups showed significant improvements in OABSS score, the number of incontinence episodes/24 h, the number of micturition episodes/24 h, and the number of episodes of urgency/24 h. The factors associated with clinically important differences in OABSS were the presence of hyperglycemia (odds ratio 2.43, 95% confidence interval [CI] 1.05-5.60) and OABSS score at baseline (odds ratio 1.23, 95% CI 1.09-1.39).

Mirabegron is effective in patients with and without MS, and comorbid hyperglycemia and severe OAB symptoms before treatment are predictors of the efficacy of mirabegron treatment.

International urogynecology journal. 2022 Jun 14 [Epub ahead of print]

Manami Kinjo, Kazuki Masuda, Yu Nakamura, Satoru Taguchi, Mitsuhiro Tambo, Hiroshi Fukuhara

Department of Urology, Kyorin University School of Medicine, 6-20-2 Shinkawa Mitaka-shi, Tokyo, 181-8611, Japan. ., Department of Urology, Kyorin University School of Medicine, 6-20-2 Shinkawa Mitaka-shi, Tokyo, 181-8611, Japan.