From the Guidelines
Betmiga (mirabegron) is an effective treatment for urinary urgency, as evidenced by its ability to decrease urgency episodes and improve symptoms of overactive bladder. According to the 2019 AUA/SUFU guideline amendment 1, mirabegron has been shown to be effective in reducing urinary incontinence episodes and improving symptoms of overactive bladder, including urgency. The study found that combination therapy with solifenacin and mirabegron was statistically superior to monotherapy with either medication for decreasing urgency episodes and improving symptoms.
Key benefits of Betmiga for urinary urgency include:
- Decreased urgency episodes
- Improved symptoms of overactive bladder
- Increased bladder capacity
- Reduced frequency of urination
The typical starting dose of Betmiga is 25mg once daily, which may be increased to 50mg once daily based on individual response 1. Common side effects include headache, increased blood pressure, urinary tract infection, and constipation. It's essential to continue taking Betmiga as prescribed and to discuss any concerns or side effects with your doctor.
In terms of efficacy, the BESIDE trial found that combination therapy with solifenacin and mirabegron was superior to monotherapy with either medication for decreasing urgency episodes and improving symptoms 1. The SYNERGY II trial also found that combination therapy was statistically superior to monotherapy with mirabegron or solifenacin for decreasing incontinence episodes and micturitions 1. Overall, the evidence suggests that Betmiga is an effective treatment for urinary urgency and can be used as a monotherapy or in combination with other medications.
From the FDA Drug Label
Mirabegron extended-release tablets are a beta-3 adrenergic agonist indicated for the treatment of: Overactive bladder (OAB) in adult patients with symptoms of urge urinary incontinence, urgency, and urinary frequency. Mirabegron was evaluated in three, 12-week, double-blind, randomized, placebo-controlled, parallel group, multicenter clinical trials in patients with overactive bladder with symptoms of urge urinary incontinence, urgency, and urinary frequency (Studies 1,2, and 3)
Betmiga (mirabegron) is effective for treating urinary urgency in patients with overactive bladder (OAB). The drug label indicates that mirabegron is indicated for the treatment of OAB in adult patients with symptoms of urge urinary incontinence, urgency, and urinary frequency. Clinical trials have shown that mirabegron is effective in reducing the number of incontinence episodes, micturitions, and increasing the volume voided per micturition. 2, 2, 2
From the Research
Efficacy of Betmiga for Urinary Urgency
- Betmiga (mirabegron) has been shown to be effective in reducing urinary urgency episodes in patients with overactive bladder syndrome 3.
- In a 12-week trial, mirabegron 50 mg once daily consistently significantly reduced urgency episodes and increased the volume of urine voided per micturition 3.
- However, a meta-analysis of four placebo-controlled trials suggested that mirabegron was poorly effective in preventing urinary incontinence episodes, with an average of one episode prevented every 2 days 4.
Comparison with Other Treatments
- Mirabegron has been compared to tolterodine in several studies, with similar efficacy and safety profiles observed 4, 5.
- A subgroup analysis of a controlled, randomized, prospective study found that mirabegron and tolterodine exhibited similar changes in urodynamics and bladder diary parameters, although mirabegron may decrease the total voided volume 5.
Safety and Tolerability
- Mirabegron has been shown to have a favorable safety and tolerability profile, with a low risk of adverse events such as dry mouth, constipation, and CNS effects 3, 6.
- Mirabegron has been found to have a lower risk of cardiac arrhythmias and other adverse events compared to antimuscarinic drugs 4.
Patient Populations
- Mirabegron has been found to be effective and safe in a variety of patient populations, including men, the elderly, and those with poor tolerability to antimuscarinics 6.
- Mirabegron has also been found to be effective in patients with OAB in Asia, with similar efficacy and safety profiles observed compared to Western populations 6.