Long-term Persistence with Mirabegron versus Solifenacin in Women with Overactive Bladder: Prospective, Randomized Trial

ObjectivesTo compare persistence with medication and the reasons for discontinuation of mirabegron or solifenacin therapy up to12months in women with overactive bladder (OAB). MethodsFemale OAB patients who presented to women's urology clinics were enrolled in a prospective, randomized, two-arm study. Patients were randomized to receive mirabegron at 25-50mg (n=76) or solifenacin at 2.5-5mg (n=72). The persistence rate and the reasons for discontinuation were investigated up to 12months. ResultsThe 12-month persistence rate was 12.2% in the mirabegron group versus 20.1% in the solifenacin group and there were no significant differences of the persistence rates during the study (n.s). Patients discontinued treatment because of lack of efficacy (21.6%), spontaneous improvement (18.2%), and side-effects (17.6%), while 19.6% were lost to follow up. Discontinuation due to side-effects was significantly more frequent in the solifenacin group than the mirabegron group (27.3 vs. 7.9%, P<0.05). In contrast, discontinuation due to lack of efficacy was significantly more frequent in the mirabegron group than the solifenacin group (36.8 vs. 5.6%, P<0.05). ConclusionsThis study demonstrated low persistence rates over 12months for both mirabegron and solifenacin, although the reasons for discontinuation were somewhat different.