Short article chosen for the September 2014 #GeriMedJC.

What does a short article mean?  In the live version of the Geriatric Medicine Journal Club held at the University of Toronto, 15 minutes is devoted to the presentation and discussion of the article.

The efficacy and tolerability of the b3-adrenoceptor agonist Mirabegron for the treatment of symptoms of overactive bladder in older patients. Age and Ageing 2014;43:666–675.

Overactive bladder symptoms are common in the elderly and adversely affect quality of life. The side effect profile of existing pharmacotherapy limits use. This study of a newer medication may be of interest. Note that #GeriMedJC has no financial conflicts of interest and articles are chosen for critical appraisal based on interest and potential impact.

The full text of the article can be found here and the abstract is posted below.

Engage in the discussion September 19, 2014 at 08:00 EDT / noon GMT and don't forget to use the hashtag #GeriMedJC. 

BACKGROUND: Mirabegron is a β3-adrenoceptor agonist developed for the treatment of symptoms of overactive bladder (OAB). As the prevalence of OAB increases with age, a prospective subanalysis of individual and pooled efficacy and tolerability data from three 12-week, randomised, Phase III trials, and of tolerability data from a 1-year safety trial were conducted in order to evaluate the efficacy and tolerability of mirabegron in subgroups of patients aged ≥65 and ≥75 years.

METHODS: Primary efficacy outcomes were change from baseline to final visit in the mean number of incontinence episodes/24 h and the mean number of micturitions/24 h. Tolerability was assessed by the incidence of treatment-emergent adverse events (TEAEs).

RESULTS: Over 12 weeks mirabegron 25 mg and 50 mg once-daily reduced the mean numbers of incontinence episodes and micturitions/24 h from baseline to final visit in patients aged ≥65 and ≥75 years. Mirabegron was well tolerated: in both age groups, hypertension and urinary tract infection were among the most common TEAEs over 12 weeks and 1 year. The incidence of dry mouth, a typical anticholinergic TEAE, was up to sixfold higher among the older patients randomised to tolterodine than any dose of mirabegron.

CONCLUSIONS: These analyses have demonstrated the efficacy of mirabegron over 12 weeks and the tolerability of mirabegron over 12 weeks and 1 year in OAB patients aged ≥65 and ≥75 years, supporting mirabegron as a therapeutic option in older patients with OAB.