Summary

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• This summary is based on the review of 27 systematic review(s)/meta-analysis(es). ^[1-27]
• In children and adolescents with idiopathic refractory overactive bladder (OAB), mirabegron monotherapy led to high improvement rates in both objective and subjective outcomes, with strong compliance across studies.
• Among adults with OAB, mirabegron 25 mg and 50 mg significantly improved urgency urinary incontinence, total incontinence, and nocturia versus placebo; mirabegron 50 mg showed greater efficacy in certain outcomes compared to tolterodine 4 mg and solifenacin 5 mg.
• For adults with neurogenic lower urinary tract dysfunction (NLUTD), mirabegron treatment significantly enhanced maximum cystometric capacity, urodynamic function, and quality of life measures, with efficacy noted in patients with both multiple sclerosis and spinal cord injury.
• In men with benign prostatic hyperplasia (BPH) and OAB, the combination of mirabegron and tamsulosin effectively improved OAB symptoms, including micturitions, urgency episodes, total symptom scores, and mean volume voided.
• Mirabegron demonstrated a generally well-tolerated safety profile, comparable to placebo in adverse events, with commonly reported side effects including nasopharyngitis, dry mouth, constipation, headache, and hypertension.
• Compared to antimuscarinics, mirabegron was associated with fewer overall adverse events, particularly lower rates of gastrointestinal disorders and dry mouth.
• In pediatric populations, common adverse effects included headaches, constipation, rhinitis/nasopharyngitis, and blurred vision.
• Studies show mirabegron is effective and safe across diverse populations, with high improvement and compliance rates in children and adolescents with idiopathic refractory OAB, significant efficacy and safety in adults with OAB (including varied age groups and ethnicities), notable urodynamic and quality-of-life benefits in adults with NLUTD (e.g., MS and SCI), effective symptom management in men with BPH and OAB when combined with tamsulosin, and a favorable safety profile for older adults, particularly regarding reduced dry mouth and constipation compared to antimuscarinics.