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10:37 - 10:43
ICCS S4-5
(LO)
DUAL THERAPY FOR REFRACTORY OVERACTIVE BLADDER IN CHILDREN: A
PROSPECTIVE OPEN-LABEL STUDY.
Stephane BOLDUC, Anne-Sophie BLAIS, Katherine MOORE and Geneviève NADEAU
CHU de Québec-Université Laval, Surgery, Quebec, CANADA
PURPOSE
To optimize pharmacotherapy in children who failed anticholinergic monotherapy by simultaneous administration of one
anticholinergic and mirabegron, a ßeta3-adrenergic agonist.
MATERIAL AND METHODS
Patients without symptoms improvement under intensive behavioural and medical therapies and/or significant S/E on
antimuscarinic dose escalation were recruited. A prospective off-label study using add-on adjusted-dose regimens of
Mirabegron (25 to 50mg) was conducted with paediatric patients presenting refractory OAB. Efficacy and tolerability
were assessed by: voiding diaries, post-void residuals, urine cultures, EKG, vital signs and UDS if judged necessary.
Families were also questioned for continence, S/E, compliance, and patient perception of bladder condition (PPBC)
questionnaire.
RESULTS
Twenty-six patients (5 girls, 21 boys) with OAB were recruited. Mean age at initiation of the second medication was
10.6±3.3 years and patients were on the add-on Mirabegron for a mean of 7.6±4.3months (minimum 3 months). Mean
bladder capacity improved from 170±77mL to 237±99mL. So far, continence improved in all patients but 3, with 6
being completely dry. Post-void residual was increased to 50ml for one patient and no UTI was reported. Mean PPBC
improved from 4.4 to 2.2. Four patients reported new mild or moderate S/E: rhinitis, abdominal cramps, constipation
and nausea. Three patients withdrew from the protocol because of lack of efficacy and/or S/E. EKG and vitals signs
remained normal.
CONCLUSIONS
Mirabegron, the first ßeta3-agonist used for the treatment of OAB, can effectively improve symptoms in children with
refractory overactive bladder. The dual therapy (antimuscarinic-Mirabegron) was well tolerated and adjusted-dose
regimen appeared safe in this first pediatric study.