Solifenacin and Mirabegron Monotherapies Versus Combination Therapy in Overactive Bladder: A Prospective Observational Study

Abstract

Overactive bladder (OAB) is a common medical condition, especially in the elderly population, that affects the quality of life. The primary treatment of OAB is a combination of behavioural measures and widely used anti-muscarinic drug therapy like solifenacin, which brings about significant side effects, thereby affecting the quality of life adversely. Mirabegron, a recently approved drug for treatment of OAB is a β3 - adrenergic agonist, which relaxes the detrusor muscle. With this background, the current study was done to compare the efficacy and safety of solifenacin, mirabegron and combination of low doses of solifenacin and mirabegron on various parameters of OAB. A total no. of 70 patients with OAB symptoms coming to urology OPD were included in this study and they were divided into 3 groups - Group 1: 24 patients receiving solifenacin 10mg/day, Group 2: 23 patients receiving solifenacin 5mg/day plus mirabegron 25mg/day, Group 3: 23 patients receiving mirabegron 50 mg/day. Patients were assessed for change in mean numbers of micturition, urgency, incontinence per 24 hour and quality of life using Patient Perception of Bladder Control (PPBC) Questionnaire. They were followed up after 4 weeks and 12 weeks and change in the above parameters from baseline were noted. Patients receiving combination therapy achieved a significant reduction in urgency, frequency, nocturia and urge incontinence and decrease in side effects when compared with solifenacin and mirabegron alone. Combination therapy with solifenacin and mirabegron significantly improved quality of life and reduced side effects like dry mouth, blurred vision, constipation in OAB patients in comparison to solifenacin and mirabegron monotherapy.