Contributions
Abstract: EP1562
Type: ePoster
Abstract Category: Therapy - symptomatic - Treatment of specific symptoms
Urinary incontinence due to neurogenic overactive bladder (OAB) is highly prevalent in Multiple Sclerosis (MS) patients (pts). Antimuscarinics (AM) are the mainly used drug class but they are burdened by the risk of urinary retention and significant side-effects. Recently Mirabegron, a selective beta-3 adrenergic agonist which relaxes detrusor muscle without compromising its contraction, has been introduced to manage this condition. Aim of our study was to describe effectiveness, tolerability and safety of Mirabegron in a series MS pts complaining OAB.
We retrospectively analyzed 18 pts treated with Mirabegron 50 mg/die for 2-12 months (mean 5.7 months), 12 females and 6 males, mean age 52.8 years (45-74), and mean EDSS 5.4 (range 2.0-7.5). 50% of pts voided by clean intermittent catheterisation (CIC); 16 pts were totally/partially resistant to AM (6 also treated with bladder botulinum toxin injections into the bladder) and 2 were naïve. We assessed the effectiveness of Mirabegron evaluating changes in Patients´s Perception of Intensity of Urgency Scale (PPIUS) (from 0 = no urgency to 4 = urge-incontinence), bladder capacity (BC) and self-reported improvement in QoL (yes or not) using 4-days micturition charts.
Overall 12 pts (66.7%) improved OAB symptoms: 10 of them (55.6%) reported an average reduction in the PPIUS of 0.9 (from 3.6 to 2.7), while 9 (50%) improved their BC of 61 ml (from 201 to 262 ml), all without side-effects and comparison/increase in post-void residual. QoL improved for 11 out of 12 pts who had improved PPIUS or BC (61% ), while all 6 non-responders pts testified non impact on their QoL. The subgorup of pts with EDSS>4.5 (n=10) showed the better response when compared to pts with EDSS< =4.5, both in term of PPIUS (mean change=-1.2 vs -0.5) and BC (mean change=+103 ml vs +6.7ml). Moreover, the benefit was reported by 63% pts in CIC and 45% of those in spontaneous micturition, with a reduction of the average consumption of pads/die from 2.5 to 1.6 and the average number of CIC/die from 4.5 to 3.7. 6 pts have to use AM in combination (2 pts solifenacina 5 mg/die and 4 pts oxybutinin at the mean dosage of 8.75 mg/die); 2 pts reported a slight reduction in effectiveness over time.
In our experience Mirabegron, alone or in combination with AM, has shown to be effective and safe in MS patients complaining of OAB, by improving BC and reducing PPIUS, without exposing pts to the risk of urinary retention or side-effects.
Disclosure: Zuliani Cristina: speaker´s bureau; membership on advisory councils from Teva, Merck Serono, Bayer, Biogen, Genzyme
Viaggi Stefano: nothing to discolse
Bertazzo Antonella: nothing to disclose
Andretta Elena: grant support from Allergan
Abstract: EP1562
Type: ePoster
Abstract Category: Therapy - symptomatic - Treatment of specific symptoms
Urinary incontinence due to neurogenic overactive bladder (OAB) is highly prevalent in Multiple Sclerosis (MS) patients (pts). Antimuscarinics (AM) are the mainly used drug class but they are burdened by the risk of urinary retention and significant side-effects. Recently Mirabegron, a selective beta-3 adrenergic agonist which relaxes detrusor muscle without compromising its contraction, has been introduced to manage this condition. Aim of our study was to describe effectiveness, tolerability and safety of Mirabegron in a series MS pts complaining OAB.
We retrospectively analyzed 18 pts treated with Mirabegron 50 mg/die for 2-12 months (mean 5.7 months), 12 females and 6 males, mean age 52.8 years (45-74), and mean EDSS 5.4 (range 2.0-7.5). 50% of pts voided by clean intermittent catheterisation (CIC); 16 pts were totally/partially resistant to AM (6 also treated with bladder botulinum toxin injections into the bladder) and 2 were naïve. We assessed the effectiveness of Mirabegron evaluating changes in Patients´s Perception of Intensity of Urgency Scale (PPIUS) (from 0 = no urgency to 4 = urge-incontinence), bladder capacity (BC) and self-reported improvement in QoL (yes or not) using 4-days micturition charts.
Overall 12 pts (66.7%) improved OAB symptoms: 10 of them (55.6%) reported an average reduction in the PPIUS of 0.9 (from 3.6 to 2.7), while 9 (50%) improved their BC of 61 ml (from 201 to 262 ml), all without side-effects and comparison/increase in post-void residual. QoL improved for 11 out of 12 pts who had improved PPIUS or BC (61% ), while all 6 non-responders pts testified non impact on their QoL. The subgorup of pts with EDSS>4.5 (n=10) showed the better response when compared to pts with EDSS< =4.5, both in term of PPIUS (mean change=-1.2 vs -0.5) and BC (mean change=+103 ml vs +6.7ml). Moreover, the benefit was reported by 63% pts in CIC and 45% of those in spontaneous micturition, with a reduction of the average consumption of pads/die from 2.5 to 1.6 and the average number of CIC/die from 4.5 to 3.7. 6 pts have to use AM in combination (2 pts solifenacina 5 mg/die and 4 pts oxybutinin at the mean dosage of 8.75 mg/die); 2 pts reported a slight reduction in effectiveness over time.
In our experience Mirabegron, alone or in combination with AM, has shown to be effective and safe in MS patients complaining of OAB, by improving BC and reducing PPIUS, without exposing pts to the risk of urinary retention or side-effects.
Disclosure: Zuliani Cristina: speaker´s bureau; membership on advisory councils from Teva, Merck Serono, Bayer, Biogen, Genzyme
Viaggi Stefano: nothing to discolse
Bertazzo Antonella: nothing to disclose
Andretta Elena: grant support from Allergan