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Current Urology Reports
Published in: Current Urology Reports 6/2013

01-12-2013 | Benign Prostatic Hyperplasia (K McVary and S Kaplan, Section Editors)

Mirabegron for Male Lower Urinary Tract Symptoms

Authors: Oscar Suarez, David Osborn, Melissa Kaufman, W. Stuart Reynolds, Roger Dmochowski

Published in: Current Urology Reports | Issue 6/2013

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Abstract

Benign prostatic hyperplasia (BPH) is a common cause of lower urinary tract symptoms (LUTS) in men. Patients with BPH often present with a combination of obstructive and overactive bladder (OAB) symptoms. It is postulated that bladder outlet obstruction (BOO) from BPH results in concomitant OAB symptoms through ischemic induced variations in the response to neurotransmitters of both the detrusor and the urothelium. This altered response leads to the pathologic activation of the micturition reflex, generating sensory dysfunction and involuntary bladder contractions. Alpha-1 adrenoceptor antagonists (alpha-blockers) and 5-alpha reductase inhibitors (5-ARIs) are commonly used to treat the BOO caused by BPH. Anticholinergic agents are frequently used to treat concurrently OAB symptoms caused by the BOO. Unfortunately, anticholinergic medications demonstrate bothersome side effects and a theoretical risk of urinary retention. Basic science and clinical research has led to the development of a new class of pharmaceuticals for the treatment of overactive bladder with diminished risk of urinary retention and lacking many anticholinergic side effects. This novel compound, mirabegron (Mybertriq, Astellas Pharma US, Inc.), is a β3-adrenoceptor agonist and represents a promising new class of oral agents designed for the treatment of OAB symptoms, with minimal effect on voiding.
Literature
1.
Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology. 2003;61:37–49.PubMedCrossRef
2.
Garraway WM, Collins GN, Lee RJ. High prevalence of benign prostatic hypertrophy in the community. Lancet. 1991;338:469–71.PubMedCrossRef
3.
Irwin DE, Kopp ZS, Agatep B, et al. Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction. BJU Int. 2011;108:1132–8.PubMedCrossRef
4.
Fullhase C, Chapple C, Cornu J-N et al. Systematic review of combination drug therapy for non-neurogenic male lower urinary tract symptoms. Eur Urol. 2013;64:228–43.
5.
Chapple CR, Roehrborn CG. A shifted paradigm for the further understanding, evaluation, and treatment of lower urinary tract symptoms in men: focus on the bladder. Eur Urol. 2006;49:651–8.PubMedCrossRef
6.
Ziada A, Rosenblum M, Crawford ED. Benign prostatic hyperplasia: an overview. Urology. 1999;53:1–6.PubMedCrossRef
7.
Irwin DE, Milsom I, Kopp Z, et al. Prevalence, severity, and symptom bother of lower urinary tract symptoms among men in the EPIC study: impact of overactive bladder. Eur Urol. 2009;56:14–20.PubMedCrossRef
8.
Sibley GN. The physiological response of the detrusor muscle to experimental bladder outflow obstruction in the pig. Br J Urol. 1987;60:332–6.PubMedCrossRef
9.
Steers WD. Pathophysiology of overactive bladder and urge urinary incontinence. Rev Urol. 2002;4 Suppl 4:S7–S18.PubMed
10.
Roosen A, Chapple CR, Dmochowski RR, et al. A refocus on the bladder as the originator of storage lower urinary tract symptoms: a systematic review of the latest literature. Eur Urol. 2009;56:810–9.PubMedCrossRef
11.
Athanasopoulos A, Chapple C, Fowler C, et al. The role of antimuscarinics in the management of men with symptoms of overactive bladder associated with concomitant bladder outlet obstruction: an update. Eur Urol. 2011;60:94–105.PubMedCrossRef
12.
Kaplan SA, Roehrborn CG, Rovner ES, et al. Tolterodine and tamsulosin for treatment of men with lower urinary tract symptoms and overactive bladder: a randomized controlled trial. JAMA. 2006;296:2319–28.PubMedCrossRef
13.
Rovner ES, Kreder K, Sussman DO, et al. Effect of tolterodine extended release with or without tamsulosin on measures of urgency and patient reported outcomes in men with lower urinary tract symptoms. J Urol. 2008;180:1034–41.PubMedCrossRef
14.
Roehrborn CG, Kaplan SA, Jones JS, et al. Tolterodine extended release with or without tamsulosin in men with lower urinary tract symptoms including overactive bladder symptoms: effects of prostate size. Eur Urol. 2009;55:472–9.PubMedCrossRef
15.
D'Souza AO, Smith MJ, Miller L-A, et al. Persistence, adherence, and switch rates among extended-release and immediate-release overactive bladder medications in a regional managed care plan. J Manag Care Pharm. 2008;14:291–301.PubMed
16.
Sacco E, Bientinesi R. Mirabegron: a review of recent data and its prospects in the management of overactive bladder. Ther Adv Urol. 2012;4:315–24.PubMedCrossRef
17.
Takeda M, Obara K, Mizusawa T, et al. Evidence for beta3-adrenoceptor subtypes in relaxation of the human urinary bladder detrusor: analysis by molecular biological and pharmacological methods. J Pharmacol Exp Ther. 1999;288:1367–73.PubMed
18.
•• Chapple CR, Kaplan SA, Mitcheson D, et al. Randomized double-blind, active-controlled phase 3 study to assess 12-month safety and efficacy of mirabegron, a beta(3)-adrenoceptor agonist, in overactive bladder. Eur Urol. 2013;63:296–305. One of the phase III trials that examined the safety and efficacy of Mirabegron in males and females with 1 year follow up.PubMedCrossRef
19.
• Nitti VW, Auerbach S, Martin N, et al. Results of a randomized phase III trial of mirabegron in patients with overactive bladder. J Urol. 2013;189:1388–95. One of the phase III trials that examined the safety and efficacy of Mirabegron in males and females that was carried out in the United States.PubMedCrossRef
20.
Khullar V, Amarenco G, Angulo JC, et al. Efficacy and tolerability of mirabegron, a beta(3)-adrenoceptor agonist, in patients with overactive bladder: results from a randomised European-Australian phase 3 trial. Eur Urol. 2013;63:283–95.PubMedCrossRef
21.
• Svalø J, Nordling J, Bouchelouche K, et al. The novel β3-adrenoceptor agonist mirabegron reduces carbachol-induced contractile activity in detrusor tissue from patients with bladder outflow obstruction with or without detrusor overactivity. Eur J Pharmacol. 2013;699:101–5. Interesting article that looked at the affect of mirabegron on bladder muscle cells in vitro.PubMedCrossRef
22.
Nitti V, Rosenberg S, Mitcheson HD et al. Urodynamics and safety of the potent and selective β3-adrenoceptor agonist, mirabegron, in males with lower urinary tract symptoms and bladder outlet obstruction. J Urol. 2013, In press
23.
Ogura K, Sengiku A, Miyazaki Y, et al. Effects of add-on mirabegron on storage symptoms in men with lower urinary tract symptoms receiving alpha-1 blocker therapy. Eur Urol Suppl. 2013;12:e1091.CrossRef
24.
Otsuki H, Kosaka T, Nakamura K, et al. β3-Adrenoceptor agonist mirabegron is effective for overactive bladder that is unresponsive to antimuscarinic treatment or is related to benign prostatic hyperplasia in men. Int Urol Nephrol. 2013;45:53–60.PubMedCrossRef
25.
Metadata
Title
Mirabegron for Male Lower Urinary Tract Symptoms
Authors
Oscar Suarez
David Osborn
Melissa Kaufman
W. Stuart Reynolds
Roger Dmochowski
Publication date
01-12-2013
Publisher
Springer US
Published in
Current Urology Reports / Issue 6/2013
Print ISSN: 1527-2737
Electronic ISSN: 1534-6285
DOI
https://doi.org/10.1007/s11934-013-0363-4

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