Overactive bladder drug mirabegron was not associated with an increased risk for cardiovascular (CV) events compared with other treatments, according to a study published in JAMA Internal Medicine.

Recently, mirabegron, the first β3-adrenoceptor agonist, has been prescribed to treat overactive bladder more frequently than antimuscarinic agents, according to the study.

“Our findings are not meant to endorse preferential use of mirabegron but to support a growing body of evidence that mirabegron is not associated with an excess risk of CV events compared with other treatments in older patients,” the authors wrote.

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Mina Tadrous, PharmD, PhD, scientist at the Women’s College Research Institute at Women’s College Hospital in Toronto, Ontario, Canada, and colleagues, conducted a matched cohort study using administrative claims data from 38,818 patients aged 66 years or older using overactive bladder treatments. 

The researchers found that patients taking mirabegron did not have an increased risk of irregular heart rates, heart attacks, or stroke compared to patients taking other overactive bladder drugs.

“These findings offer a measure of reassurance for the decision-makers regarding the safety of mirabegron, a drug with growing utilization,” Tadrous told FormularyWatch.

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“Real-world data on older patients with overactive bladder who have concomitant cardiovascular comorbidities such as poorly controlled hypertension, arrhythmia, or heart failure is lacking,” he says. “Moreover, there are limited long-term safety data for patients using mirabegron. Real-world evidence is essential for clinicians to make informed decisions.”

The study also found a 79% prevalence of hypertension and 36% prevalence of diabetes in the cohort, substantially higher than that in clinical trials. 

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