Impact of mirabegron on nocturnal enuresis in children with overactive bladder
DOI:
https://doi.org/10.18203/2349-3291.ijcp20261133Keywords:
Mirabegron, Nocturnal enuresis, Overactive bladder, Pediatric urology, β3-adrenergic agonistAbstract
Background: Nocturnal enuresis associated with overactive bladder (OAB) is a common pediatric voiding disorder that can disrupt daily life and psychosocial well-being. Mirabegron, a β3-adrenergic receptor agonist, has emerged as an alternative to antimuscarinic therapy for OAB. This study aimed to evaluate the therapeutic effect of mirabegron on nocturnal enuresis in children with OAB.
Methods: This quasi-experimental study was conducted over 18 months in the Department of Pediatric Nephrology at the National Institute of Kidney Diseases and Urology, Dhaka. Thirty children aged 6–15 years with nocturnal enuresis and OAB were enrolled following informed consent. Clinical, demographic, urodynamic, and laboratory data were recorded. All participants received mirabegron 25 mg at bedtime for 3 months. Bedwetting frequency, urgency, and overall treatment response were assessed at baseline and at monthly follow-up visits.
Results: The mean age of participants was 11.33±2.44 years, and 70% were male. Urodynamic evaluation showed that 60% had small-capacity, reduced-compliance OAB. The mean number of bedwetting episodes decreased significantly from 7.3±3.4 per month at baseline to 4.7±3.6, 0.33±0.66, and 0.1±0.3 at the 1st, 2nd, and 3rd follow-ups, respectively. Urgency also decreased progressively, with 90% of children achieving complete symptom resolution by the end of treatment. No adverse effects were reported.
Conclusions: Mirabegron demonstrated marked effectiveness in reducing nocturnal enuresis among children with OAB, with significant improvement in both bedwetting frequency and urgency. Larger multicenter studies are recommended.
References
Srivastava RN, Bagga A. Pediatric Nephrology. New Delhi: Jaypee Brothers Medical Publishers. 2016;31-618.
Proserpio P, Terzaghi M, Manni R, Nobili L. Drugs Used in Parasomnia. Sleep Med Clin. 2018;13(2): 191-202.
Graham KM, Levy JB. Enuresis. Pediatr Rev. 2009;30(5):165-72.
Thurber S. Childhood Enuresis: Current Diagnostic Formulations, Salient Findings, and Effective Treatment Modalities. Arch Psychiatr Nurs. 2017;31(3):319-23.
Tsai JD, Chen HJ, Ku MS, Chen SM, Hsu CC, Tung MC, et al. Association between allergic disease, sleep-disordered breathing, and childhood nocturnal enuresis: a population-based case-control study. Pediatr Nephrol. 2017;32(12):2293-301.
Dossche L, Vande Walle J, Van Herzeele C. The pathophysiology of monosymptomatic nocturnal enuresis with special emphasis on the circadian rhythm of renal physiology. Eur J Pediatr. 2016;175(6):747-54.
Vande Walle J, Rittig S, Bauer S, Eggert P, Marschall-Kehrel D, Tekgul S. Practical consensus guidelines for the management of enuresis. Eur J Pediatr. 2012;171(6):971-83.
Sakr A, Farkash F, Desouki H, Elsayed E. Effectiveness of Mirabegron in Children with Nocturnal Enuresis. J Pharm Negative Results. 2023;14(3):866-9.
Kanwal Kher H, Schnaper W, Greenbaum LA. Clinical Pediatric Nephrology. 2017.
Lee CL, Ong HL, Kuo HC. Therapeutic efficacy of mirabegron 25 mg monotherapy in patients with nocturia-predominant hypersensitive bladder. Tzu Chi Med J. 2020;32(1):30-5.
Wagg A, Cardozo L, Nitti VW, Castro-Diaz D, Auerbach S, Blauwet MB, et al. The efficacy and tolerability of the β3-adrenoceptor agonist mirabegron for the treatment of symptoms of overactive bladder in older patients. Age ageing. 2014;43(5):666-75.
Kim JK, De Jesus MJ, Lee MJ, Dos Santos J, Dy JS, Ming JM, et al. β3-Adrenoceptor Agonist for the Treatment of Bladder Dysfunction in Children: A Systematic Review and Meta-Analysis. J Urol. 2022;207(3):524-33.
Salem Algethami S, Ahmed Albarq A. Pharmaceutical Sciences Prevalence and Risk Factors of Nocturnal Enuresis Among Children of Parents Attending Primary Healthcare Centers, Ministry of Health, Taif. IAJPS. 2022;2022(3):81-95.
Shah S, Jafri RZ, Mobin K, Mirza R, Nanji K, Jahangir F, et al. Frequency and features of nocturnal enuresis in Pakistani children aged 5 to 16 years based on ICCS criteria: A multi-center cross-sectional study from Karachi, Pakistan. BMC Fam Pract. 2018;19(1):1-9.
Maternik M, Chudzik I, Krzeminska K, Żurowska A. Evaluation of bladder capacity in children with lower urinary tract symptoms: Comparison of 48-hour frequency/volume charts and uroflowmetry measurements. J Pediatr Urol. 2016;12(4):1-214.
Lee CL, Ong HL, Kuo HC. Therapeutic efficacy of mirabegron 25 mg monotherapy in patients with nocturia-predominant hypersensitive bladder. Tzu Chi Med J. 2020;32(1):30-5.
Chung JM, Lee SD, Cho WY. Evaluation of bladder capacity in children with nocturnal enuresis: comparison of 48-hour frequency-volume charts and uroflowmetry measurements. J Pediatr Urol. 2020;16:1.
Blais AS, Nadeau G, Moore K, Genois L, Bolduc S. Prospective Pilot Study of Mirabegron in Pediatric Patients with Overactive Bladder. Eur Urol. 2016;70(1):9-13.
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