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Persistence and adherence with mirabegron versus antimuscarinics in overactive bladder: retrospective analysis of a UK General Practice Prescription Database
]. The study objective was to investigate persistence with the beta-adrenoceptor agonist mirabegron (MIR).
Materials and methods: Retrospective cohort analysis of a UK longitudinal GP prescription database. Patients were aged ≥18y, initiated OAB monotherapy in the 6 months to 31/05/2014, and were in the database ≥12 months before and after the start date. ‘Persistence’ was defined as time-to-discontinuation, with a 30-day grace period.
Results: The total cohort included 6189 patients (34% male, mean age 63.8y). Compared with AMs, MIR patients (n = 379) were more likely to be treatment-experienced (45.6% vs 4.7–27.1%) and be taking more concomitant medication classes (mean 8.9 vs 5.4–7.5). MIR was associated with a longer median time-to-discontinuation (Fig. 1), greater persistence at 12 months (24% vs 10–19%), and a significantly lower risk of discontinuation in univariate and multivariate analyses (p < 0.01 vs each AM). Adherence was significantly greater with MIR vs AMs (mean medication possession ratio 48% vs 28–40%, p < 0.001).
Fig. 1Median time to discontinuation of mirabegron and antimuscarinics (cumulative survival, %).
Interpretation of results: MIR was associated with better persistence than AMs. The decline in persistence with all drugs after 1 month underlines the importance of early follow-up and counselling.
Conclusions: MIR gave a longer time-to-discontinuation and significantly better persistence than AMs.
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