Use and Persistence of Beta 3-Adrenoceptor Agonists for the Treatment of Overactive Bladder.

INTRODUCTION

This study aimed to investigate the real-world usage patterns and persistence rates of mirabegron and vibegron in the treatment of overactive bladder (OAB).

METHODS

A retrospective review was conducted on patients who received either mirabegron or vibegron as their initial treatment for OAB between August 2022 and December 2024. Two types of persistence rates were assessed: (1) the individual persistence for each drug (persistence rate I) and (2) the overall β3-adrenergic agonist persistence among patients who switched between mirabegron and vibegron (persistence rate II).

RESULTS

In total, 192 patients were included, with 128 (66.7%) receiving mirabegron and 64 (33.3%) receiving vibegron. Mirabegron was more commonly prescribed to male patients. The median persistence rate I was 11 months for mirabegron (95% CI, 6-16) and was not reached for vibegron (95% CI, 9 months to not estimable) (p = 0.071). Among those who discontinued treatment, 40.7% of mirabegron users and 17.6% of vibegron users switched to the alternative β3 agonist. The median persistence rate II was 16 months for mirabegron (95% CI, 8-20) and not reached for vibegron (95% CI, 9 months to not estimable) (p = 0.352).

CONCLUSION

The higher discontinuation rate of mirabegron may reflect the availability of vibegron as an alternative treatment option. The complementary use of both β3 agonists could play a key role in optimizing OAB management.