Efficacy of behavioral therapy and different dosages of mirabegron for the treatment of male overactive bladder patients.

PURPOSE: Behavioral therapy is the established first-line treatment for overactive bladder (OAB), followed by pharmacotherapy as the second-line intervention. Mirabegron, a β3-adrenoceptor agonist, has demonstrated comparable efficacy to antimuscarinics. This study aims to evaluate the real-world efficacy of behavioral therapy, both as a monotherapy and in combination with mirabegron, for male patients with OAB.

METHODS

This pooled analysis from three studies involved 280 adult male OAB patients assigned to behavioral therapy alone or combined with mirabegron (25 mg or 50 mg) for 12 weeks. The primary outcome was the change in the Overactive Bladder Symptom Score (OABSS) from baseline to week 12. Secondary outcomes included changes in the International Prostate Symptom Score (IPSS), Patient Perception of Bladder Condition (PPBC), Quality of Life (QOL) score, maximum flow rate (Qmax), and post-void residual (PVR) volume.

RESULTS

At week 12, all groups exhibited significant within-group improvements in total OABSS, with no statistically significant inter-group differences. Significant improvements were also observed in the IPSS, QOL, PPBC, urge urinary incontinence (UUI), and nocturia across all groups. Notably, behavioral therapy demonstrated substantial therapeutic potential for storage symptoms (IPSS storage sub-score), particularly regarding UUI and nocturia. No negative impacts on PVR or Qmax were observed across the three treatment arms at week 12.

CONCLUSION

In real-world clinical practice, both behavioral therapy and combination therapy with varied dosages of mirabegron effectively alleviate OAB symptoms in male patients without compromising voiding function. Beyond conventional pharmacotherapy, optimizing the role of behavioral therapy remains a fundamental component of comprehensive OAB management.