PMID- 36303599 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20221029 IS - 1745-1981 (Print) IS - 1740-4398 (Electronic) IS - 1740-4398 (Linking) VI - 11 DP - 2022 TI - Long-term efficacy and safety of vibegron versus mirabegron and anticholinergics for overactive bladder: a systematic review and network meta-analysis. LID - 10.7573/dic.2022-4-2 [doi] LID - 2022-4-2 AB - BACKGROUND: Few randomized controlled trials evaluate the long-term efficacy and safety of pharmacotherapy for overactive bladder (OAB). This network meta- analysis compares the long-term (52-week) efficacy and safety of vibegron, mirabegron and anticholinergics for the treatment of OAB. METHODS: A systematic literature review and network meta-analysis were conducted following PRISMA guidelines using MEDLINE, Embase and Cochrane Central Register of Controlled Trials and terms related to OAB. Efficacy outcomes included change from baseline to week 48-52 in mean daily total urinary incontinence (UI) episodes, mean daily number of micturitions and volume voided/micturition. Efficacy outcomes were analysed using Bayesian models. Commonly reported adverse events (AEs) are described. RESULTS: Of 2098 hits retrieved, 5 publications and 1 study report describing 5 unique randomized controlled trials were included in the analyses. Mean (95% credible interval) change from baseline in total UI episodes for vibegron 75 mg (-2.2; -2.9 to -1.5) showed a significantly greater reduction than mirabegron 50 mg (-1.3; -1.9 to -0.8) and tolterodine 4 mg extended release (-1.6; -2.1 to -1.1). No significant differences were observed between vibegron and comparators for daily micturitions or volume voided/micturition. Within the manuscripts, the 4 most common AEs (range) for anticholinergics included dry mouth (5.2-90.0%), constipation (7.7-65.0%), blurred vision (3.8-35.0%) and hypertension (8.6-9.6%); the 4 most commonly reported AEs for beta(3)-adrenergic agonists included hypertension (8.8-9.2%), urinary tract infection (5.9-6.6%), headache (5.5%) and nasopharyngitis (4.8-5.2%). CONCLUSION: Vibegron was associated with significantly greater improvement in daily total UI episodes at 52 weeks than mirabegron and tolterodine. When reported, the most common AE for anticholinergics was dry mouth and for beta(3)-adrenergic agonists was hypertension. Hypertension incidence was similar between drug classes. CI - Copyright (c) 2022 Kennelly M, Wielage R, Shortino D, Thomas E, Mudd PN Jr. FAU - Kennelly, Michael AU - Kennelly M AD - Carolinas Medical Center, Charlotte, NC, USA. FAU - Wielage, Ronald AU - Wielage R AD - Medical Decision Modeling, Indianapolis, IN, USA. FAU - Shortino, Denise AU - Shortino D AD - Urovant Sciences, Irvine, CA, USA. FAU - Thomas, Elizabeth AU - Thomas E AD - Urovant Sciences, Irvine, CA, USA. FAU - Mudd, Paul N Jr AU - Mudd PN Jr AD - Urovant Sciences, Irvine, CA, USA. LA - eng PT - Journal Article DEP - 20221010 PL - England TA - Drugs Context JT - Drugs in context JID - 101262187 PMC - PMC9576010 OTO - NOTNLM OT - adrenergic beta-3 receptor agonists OT - antimuscarinic OT - medication persistence OT - micturition OT - urinary bladder OT - urinary incontinence COIS- Disclosure and potential conflicts of interest: MK is a consultant for Allergan, Astellas, Boston Scientific, Coloplast, Laborie, and Urovant Sciences and has received grant or research study funding from Allergan, Amphora, Axonics, Boston Scientific, Coloplast, Cook Myosite, Dignify Therapeutics, EBT Medical, FemPulse, Ipsen, Taris and Uro-1. RW is an employee of Medical Decision Modeling, a consultancy working for Urovant Sciences. ET is an employee of Urovant Sciences. DS and PNM were employees of Urovant Sciences at the time the work was conducted. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2022/08/dic.2022-4-2-COI.pdf EDAT- 2022/10/29 06:00 MHDA- 2022/10/29 06:01 PMCR- 2022/10/10 CRDT- 2022/10/28 02:35 PHST- 2022/04/20 00:00 [received] PHST- 2022/08/18 00:00 [accepted] PHST- 2022/10/28 02:35 [entrez] PHST- 2022/10/29 06:00 [pubmed] PHST- 2022/10/29 06:01 [medline] PHST- 2022/10/10 00:00 [pmc-release] AID - dic-2022-4-2 [pii] AID - 10.7573/dic.2022-4-2 [doi] PST - epublish SO - Drugs Context. 2022 Oct 10;11:2022-4-2. doi: 10.7573/dic.2022-4-2. eCollection 2022.