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Effective treatment of neurogenic detrusor overactivity in multiple sclerosis patients using desmopressin and mirabegron.

TitleEffective treatment of neurogenic detrusor overactivity in multiple sclerosis patients using desmopressin and mirabegron.
Publication TypeJournal Article
Year of Publication2017
AuthorsZachariou, A., Filiponi M., Baltogiannis D., Giannakis J., Dimitriadis F., Tsounapi P., Takenaka A., & Sofikitis N.
JournalCan J Urol
Volume24
Issue6
Pagination9107-9113
Date Published2017 Dec
ISSN1195-9479
KeywordsAcetanilides, Adrenergic beta-3 Receptor Agonists, Adult, Antidiuretic Agents, Deamino Arginine Vasopressin, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Multiple Sclerosis, Muscarinic Antagonists, Retreatment, Solifenacin Succinate, Thiazoles, Urinary Bladder, Neurogenic, Urinary Bladder, Overactive, Urinary Incontinence, Urination
Abstract

INTRODUCTION: Multiple sclerosis (MS) is the commonest progressive neurological disease affecting young people. With advancing disease, management of neurogenic detrusor overactivity (NDO) based on antimuscarinics may prove inadequate and if based on botulinum toxin, may necessitate clean intermittent self-catheterization. The aim of the study was to evaluate the effectiveness of combined mirabegron and desmopressin administration in the treatment of NDO in patients with MS.
MATERIALS AND METHODS: Sixty patients diagnosed with MS and NDO were evaluated. All had received treatment with solifenacin 10 mg/daily for 3 months and were displeased with the results. Patients were divided in four groups. In Group A (n = 15) patients continued receiving solifenacin 10 mg/daily; in Group B (n = 15) patients received mirabegron 50 mg/daily; in Group C (n = 15) patients received desmopressin 120 mcg/daily and in Group D (n = 15) patients received mirabegron 50 mg/daily and desmopressin 120 mcg/daily. All patients were assessed with a 3 day bladder diary at the beginning and at the end of the treatment.
RESULTS: All patients in Groups A, B and C did not demonstrate statistically significant changes at the end of the treatment period in their 3 day bladder diary and in the presence of urinary infections. In Group D, a statistically significant improvement was noted in the mean change from baseline to end of treatment in micturition episodes (3.5 +/- 0.4 micturition/24h), in urgency episodes (2.3 +/- 0.2) and mean number of urinary incontinence (1.0 +/- 0.2 episodes/24h).
CONCLUSIONS: Treatment with mirabegron and desmopressin revealed both effectiveness and safety in patients with NDO and MS.

Alternate JournalCan J Urol
PubMed ID29260636

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