data for combinations of mirabegron with
antimuscarinics or the use of 2 or more different
antimuscarinics were not captured).
If a first
antimuscarinic medication doesn't work or causes unacceptable side effects, modify the dose or offer a different
antimuscarinic or beta3-adrenoceptor agonist, the guideline states.
Oral
antimuscarinics are effective in reducing frequency, urgency, and incontinence.
Antimuscarinics work by binding to muscarinic receptors in the bladder and inhibiting involuntary bladder contractions.
These side effects are one major reason that patients stop OAB
antimuscarinic medications.
Antimuscarinics and Overactive Bladder: Other Mechanism of Action.
Efficacy of mirabegron in patients with and without prior
antimuscarinic therapy for overactive bladder (OAB): Post-hoc analysis of a prospective, randomised European-Australian phase III trial.
Antimuscarinic mechanisms and the overactive detrusor: an update.
These drugs are also
antimuscarinics, intended to relax the smooth muscle of the bladder.
Poor understanding of the disorder and limited treatment options means that many physicians have resorted to using
antimuscarinics despite their limited proven efficacy in treating the pain.
In this survey of 519 physicians, (regarding 5,316 patients), pooled data across France, Germany, Spain and the UK found that the most common reason for switching
antimuscarinics was lack of efficacy alone, accounting for 36% of 1,067 patients who switched therapy.
The major benefit of mirabegron is its lack of
antimuscarinic side effects.