Vol. 8, Issue 9, Part C (2022)

Introduction and Objectives: Overactive bladder (OAB) with symptoms of frequency, urgency with or without urgency incontinence and nocturia is one of the most bothersome symptom affecting the quality of life of both men and women. Antimuscarinics and Beta 3 agonists both play an important role in reducing the bothersome symptoms. In this study we find the efficacy of low dose combination therapy of solifenacin 5 mg with mirabegron 25 mg vs the monotherapy solifenacin 10 mg or Mirabegron 50 mg.

Materials and Methods: It is a prospective study conducted on 150 patients at Madras medical college and were divided into 3 groups. Group A received solifenacin 10 mg/day, Group B received solifenacin 5 mg/day + Mirabegron 25 mg/day and Group C received Mirabegron 50 mg/day. Patients were evaluated for improvement in frequency, urgency, leak episodes, voided volume and improvement in quality of life after a period of 4 weeks and 12 weeks. The three groups were compared using anova test and chi square test and p value was calculated.

Results and Observations: Majority of patients of OAB belong to age group > 50 years and majority were females showing female predilection towards OAB. The mean duration of symptoms was 36.01± 7.91 months. Compared with monotherapy, the combination therapy resulted in a significant improvement in reducing the mean number of micturition/24hr from baseline to End of Treatment (EoT). The frequency of urgency episodes and mean number of nocturia episodes/24hr was significantly reduced in patients taking combination therapy as compared to monotherapy. In all the groups a decrease in mean number of incontinence episodes/24hr was observed from baseline to EoT but was not statistically significant. The frequency of antimuscarinic side effects (dry mouth, constipation, urinary retention) had lower incidence in combination therapy compared with solifenacin group.

Conclusions: Combination therapy of solifenacin and mirabegron demonstrated significant improvement over monotherapy (solifenacin 10 mg & mirabegron 50 mg) in frequency of micturition, urgency and nocturia episodes without increasing bothersome adverse effects associated with antimuscarinic therapy.