Vibegron 50 mg is the optimal algorithm in the pharmacologic management of overactive bladder: outcomes from a systematic review and meta-analysis.

The efficacy and safety of vibegron, which is a novel β3-adrenoceptor agonist, need to be systematically evaluated in the treatment of overactive bladder (OAB) patients. This study aimed to assess, using meta-analytic methods, the efficacy and safety of vibegron for OAB compared with placebo or antimuscarinics, considering all available data from comparative studies.

A systematic search was performed on MEDLINE, Web of Science, and Cochrane Central Register of Controlled Trials database to identify studies from their date of inception before 15 March 2020. Meta-analysis was performed based on eligible studies.

Six studies derived from four clinical trials with 4314 randomized patients were finally included in our analysis. We found that vibegron 50 mg and 100 mg were both significantly more efficacious than placebo for all efficacy outcomes. Furthermore, no significant differences were found between vibegron 50 mg or 100 mg and placebo for all the AEs assessed. In addition, the efficacy between vibegron 50 mg or 100 mg and antimuscarinics were comparable except for voided volume. Moreover, vibegron was associated with a decreased risk of dry mouth and an increased risk of nasopharyngitis versus antimuscarinics. Our study also demonstrated that the vibegron 50 mg and 100 mg were equally effective and safe across all the efficacy and AEs' outcomes.

Vibegron is effective and safe for treating patients with OAB. Based on the current evidence, we recommended that the initial use of vibegron 50 mg was the optimal algorithm in the pharmacologic management of OAB.

International urology and nephrology. 2020 Jun 09 [Epub ahead of print]

Zhongyu Jian, Chi Yuan, Hong Li, Wei Zhang, Kunjie Wang

Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, People's Republic of China., West China Biomedical Big Data Center, Sichuan University, Chengdu, People's Republic of China., Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, People's Republic of China. .