Comparison of the 3-Year Continuation Rate and Discontinuation Factors Between Vibegron and Mirabegron in Patients With Overactive Bladder: A Retrospective Follow-Up Study in a Rehabilitation Hospital in Japan

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY LUTS: Lower Urinary Tract Symptoms Pub Date : 2024-12-04 DOI:10.1111/luts.70001

Shigeto Mukai, Masashi Nomi, Akihiro Yanagiuchi, Atsushi Sengoku

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Abstract

Objectives

The objective of this study is to compare the 3-year continuation rate and discontinuation factors between vibegron and mirabegron in patients with overactive bladder in a rehabilitation hospital in Japan.

Methods

The 3-year continuation rate of the target drugs and reasons for discontinuation as well as patients' backgrounds and adverse effects were evaluated retrospectively from the medical records between September 2018 and December 2020. After selecting patients according to our inclusion and exclusion criteria, 136 cases taking mirabegron and 82 taking vibegron were adjusted for intergroup variability by propensity score matching. We performed Cox proportional hazards regression for the 3-year continuation rate and Fine-Gray proportional hazards regression for the 3-year cumulative incidence of discontinuation events. Subgroup analysis was also performed.

Results

Approximately 70% of the patients analyzed had neurogenic overactive bladder. The 3-year continuation rate was 65.2% in vibegron and 30.3% in mirabegron, and the hazard ratio was 0.41 (95% confidence interval: 0.25–0.68, p < 0.001) as for an incidence of discontinuation events of vibegron against mirabegron. The incidence of discontinuation due to inadequate efficacy was 22.7% in vibegron and 47.0% in mirabegron, and similarly the hazard ratio was 0.43 (95% confidence interval: 0.23–0.80, p < 0.01). In the subgroup analysis, vibegron continued significantly more than mirabegron for the 3-year continuation rate in non-neurogenic overactive bladder (p < 0.001), in spontaneous voiding (p < 0.001), in anticholinergic combination (p = 0.0017), in female (p < 0.001), and in 70 years or older (p = 0.0028). Additionally, a significant interaction was observed regarding the methods of emptying urine (p = 0.0066).

Conclusions

Vibegron was superior to mirabegron in the 3-year continuation rate of administration with a fewer discontinuation due to inadequate efficacy in a patient population with relatively high rates of neurogenic overactive bladder.

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日本一家康复医院的回顾性随访研究：威比格隆与美拉贝格隆治疗膀胱过动症患者3年延续率及停药因素的比较

目的：本研究的目的是比较日本一家康复医院治疗膀胱过动症患者的维比格龙和米拉贝格龙的3年延续率和停药因素。方法：回顾性分析2018年9月至2020年12月的病历资料，评估目标药物的3年延续率、停药原因、患者背景和不良反应。根据我们的纳入和排除标准选择患者后，通过倾向评分匹配调整136例米拉比格龙和82例威比格龙组间变异性。我们对3年持续率进行了Cox比例风险回归，对3年累计停药事件发生率进行了Fine-Gray比例风险回归。并进行亚组分析。结果：约70%的患者为神经源性膀胱过动症。vibegron的3年延续率为65.2%，mirabegron的3年延续率为30.3%，风险比为0.41（95%可信区间：0.25-0.68,p）。结论：在神经源性膀胱过度活跃率相对较高的患者群体中，vibegron的3年延续率优于mirabegron，且较少因疗效不足而停药。

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来源期刊

LUTS: Lower Urinary Tract Symptoms UROLOGY & NEPHROLOGY-

CiteScore

3.00

自引率

7.70%

发文量

审稿时长

>12 weeks

期刊介绍： LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided. LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.