Abstract General Information

Title

CUMULATIVE SYMPTOMATIC EFFICACY OF MIRABEGRON IN REFRACTORY OVERACTIVE BLADDER IN CHILDREN: A THREE AND-A-HALF YEAR RETROSPECTIVE SINGLE-CENTRE REVIEW

Introduction and objective

Overactive bladder (OAB) is a prevalent condition in paediatric patients, and conventional treatments like anticholinergic (AC) medication and urotherapy may not be effective in all cases. This study aimed to evaluate the efficacy of Mirabegron, either alone or in combination with AC, over time in paediatric patients with significant refractory OAB (2-3.5 years).

Method

A retrospective review was conducted at a single centre, analyzing LUTS at the start of Mirabegron therapy, 6, 12, 24 months, and at median final follow-up 43 months (24-76m). 84 paediatric patients (56% female, mean age 11 years) with urodynamically proven DO and persistent LUTS despite anticholinergic medication and urotherapy were included. Mirabegron was administered at daily doses of 25-50mg. Kaplan Meier analysis was undertaken to demonstrate cumulative effect.

Results

At baseline, the majority of patients experienced urinary urgency (81%), daytime wetting (75%), enuresis (80%), and combined day and nighttime wetting (58%). At 6 months, 71% of patients remained on Mirabegron treatment, with 66% reporting improvement and 50% receiving combination therapy with AC(+/- desmopressin). Similar trends were observed at 12 and 24 months, with 63% and 45% of patients, respectively, continuing Mirabegron treatment. At 43 (24-76) months, 21 patients were still on treatment, with 71% receiving combination therapy. Overall, 73% of patients showed a good response to treatment, with 54% achieving dryness (on or off meds) and an additional 19% showing partial response. Mean duration of Mirabegron therapy was 25.9 months. The greatest effect of treatment is seen in the first 6 months with slower treatment effect thereafter and little change after 24 months. Fig. 1. During follow-up, 19% of patients reported AEs, and 4 patients discontinued treatment.

Conclusion

Mirabegron (monotherapy or combination with AC) demonstrates an effective and well-tolerated treatment option for paediatric patients with refractory LUTS. The greatest effect is seen within the first 6 months of treatment and nearly half of patients experience symptom resolution by 24 months with little change thereafter.

Area

Enuresis