Clinical efficacy of mirabegron in the treatment of female patients with Parkinson’s disease and overactive bladder

Abstract

Objective: To compare short-term clinical outcomes and adverse events associated with mirabegron and tolterodine treatment in female patients with Parkinson’s disease (PD) and overactive bladder (OAB).

Methodology: This retrospective cohort analysis included 90 female patients with PD and OAB treated in Huzhou Third Municipal Hospital from January 2021 to October 2024. The final study cohort comprised 45 patients receiving mirabegron and 45 patients receiving tolterodine, selected in a 1:1 ratio with consideration of available baseline clinical characteristics. The primary efficacy outcome was the change in Overactive Bladder Symptom Score (OABSS) from baseline to 12 weeks. Secondary outcomes included changes in urinary diary variables and the occurrence of adverse events, while changes in the Nonmotor Symptoms Scale (NMSS) and Pittsburgh Sleep Quality Index (PSQI) were considered exploratory outcomes.

Results: A significant group × time interaction was observed for urgency episodes/24 hours (IRR=0.684, 95% CI 0.515–0.908, P=0.009), indicating a greater reduction over time in the mirabegron group. No significant interactions were observed for nocturia episodes/night (IRR=0.938, 95% CI 0.794–1.108, P=0.450) or micturitions /24 hours(IRR=0.962, 95% CI 0.906–1.021, P=0.202). Significant group × time interactions were also observed for OABSS (estimate=−0.422, 95% CI −0.813 to −0.031, P=0.034) and PSQI (estimate=−1.956, 95% CI −3.098 to −0.813, P=0.001), whereas the interaction for NMSS was not significant (estimate=0.244, 95% CI −0.754 to 1.243, P=0.631). There was no significant difference in the incidence of individual adverse events between the two groups after treatment (P>0.05). However, the proportion of patients experiencing at least one adverse event was significantly lower in the mirabegron group than in the tolterodine group (20.0% vs. 44.4%, P=0.013).

Conclusions: In this retrospective cohort of female patients with PD and OAB, mirabegron treatment was associated with greater short-term improvements in selected OAB-related outcomes and sleep quality, as well as a lower proportion of patients experiencing adverse events, compared with tolterodine over 12 weeks. These findings require confirmation in prospective randomized studies.