What’s new in functional urology research?

Oral pharmacotherapies for the treatment of OAB include antimuscarinics such as solifenacin and the beta-3 adrenoceptor (β3AR) agonist mirabegron. Although both classes of drugs are similarly effective, the antimuscarinics have been associated with bothersome anticholinergic side effects, such as dry mouth and constipation, that can lead to treatment discontinuation. The randomized, double-blind, multicentre, phase 3 BESIDE study showed that add-on therapy with mirabegron 50 mg for 12 weeks provided additional improvements in OAB symptoms for incontinent OAB patients who experience an insufficient response to solifenacin 5 mg compared with solifenacin 5 mg or 10 mg monotherapy.1 Since antimuscarinics and β3AR agonists are both potentially autonomically active, the BESIDE investigators examined cardiovascular outcomes in this study population, and reported these results at EAU 2016.2 Key parameters of blood pressure and pulse rate were assessed at screening, baseline, and intervals throughout the study. Electrocardiogram (ECG) results were also assessed at screening, baseline, and end of study. No clinically meaningful differences in blood pressure or heart rate were observed between the treatment groups, and there were no significant changes in ECG properties. These results provide some assurance that the addition of mirabegron to solifenacin in patients with incontinent OAB who have an inadequate response to solifenacin does not increase risk of cardiovascular adverse events