Real-life data on mirabegron in neurogenic bladder dysfunction

Aims: To determine factors for treatment persistence in a real-life cohort of adult neurogenic lower urinary tract dysfunction. Methods: We reviewed records of patients with neurogenic lower urinary tract dysfunction and mirabegron prescriptions. Exclusion criteria were indwelling urethral or suprapubic catheters and implanted neurostimulators. We extracted demographic data, indication for prescription, concomitant use of other agents with possible anticholinergic effect, beta blockers, duration of treatment and reason of discontinuation. Results: We included 110 subjects in this study. Neurologic diagnoses included multiple sclerosis, Parkinson's disease, and other diagnoses (dementia, paraplegia, and tetraplegia). Previous usage of antimuscarinics was found in 78 patients (71%). Mirabegron was combined with antimuscarinics in 15 patients (14%). Drugs with any anticholinergic activity were taken by 94 subjects (86%). Mirabegron was taken for a median of 497 days and 60 patients discontinued the medication within the study period. Main reasons of discontinuation were lack of effect (44/110), side effects (10/110), and non-reimbursement (6/110). There were no differences in mirabegron discontinuation by neurological disease, beta blocker usage, or anticholinergic burden. Conclusions: Mirabegron is continued in more than half of patients with neurogenic lower urinary tract dysfunction for more than 6 months. Further research is needed to identify eventual predictive factors.