Pelvic floor exercises are more effective in subjective and objective outcomes with biofeedback or verbal feedback .
Weight loss with diet and exercise , caffeine reduction , 25 - 50 % reduction in fluid intake , and pelvic floor muscle exercises with verbal instruction and or biofeedback were all efficacious .
Botulinum toxin A improves urge incontinence episodes , urgency , frequency , quality of life , nocturia , and urodynamic testing parameters .
Acupuncture  improves quality of life and urodynamic testing parameters .
Extracorporeal magnetic stimulation improves urodynamic parameters .
Mirabegron improves daily incontinence episodes , nocturia , number of daily voids , and urine volume per void , whereas solabegron improves daily incontinence episodes .
Short-term posterior tibial nerve stimulation is more efficacious than pelvic floor muscle training exercises and behavioral therapy for improving : urgency , urinary incontinence episodes , daily voids , volume per void , and overall quality of life .
Sacral neuromodulation is more efficacious than antimuscarinic treatment for subjective improvement of overactive bladder and quality of life .
Transvaginal electrical stimulation demonstrates subjective improvement in overactive bladder symptoms and urodynamic parameters .
Multiple therapies , including physical therapy , behavioral therapy , botulinum toxin A , acupuncture , magnetic stimulation , mirabegron , posterior tibial nerve stimulation , sacral neuromodulation , and transvaginal electrical stimulation , are efficacious in the treatment of overactive bladder
The purpose of the study was to determine the efficacy and safety of nonantimuscarinic treatments for overactive bladder .
Randomized double-blind, active-controlled phase 3 study to assess 12-month safety and efficacy of mirabegron, a β(3)-adrenoceptor agonist, in overactive bladder.
BACKGROUND Despite several antimuscarinic treatment options for overactive bladder ( OAB ) , there is still a need for distinct treatment approaches to manage this condition . Mirabegron , a β(3)-adrenoceptor agonist , has demonstrated efficacy and tolerability for up to 12 wk in phase 3 trials . OBJECTIVE To assess the 12-mo safety and efficacy of mirabegron . DESIGN , SETTING , AND PARTICIPANTS Patients ≥ 18 yr of age with OAB symptoms for ≥ 3 mo . INTERVENTIONS After a 2-wk single-blind placebo run-in , patients with eight or more micturitions per 24h and three or more urgency episodes in a 3-d micturition diary were r and omized 1:1:1 to once-daily mirabegron 50 mg , mirabegron 100 mg , or tolterodine extended release ( ER ) 4 mg for 12 mo . OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Primary variable : incidence and severity of treatment-emergent AEs ( TEAEs ) . Secondary variables : change from baseline at months 1 , 3 , 6 , 9 , and 12 in key OAB symptoms . RESULTS AND LIMITATIONS A total of 812 , 820 , and 812 patients  received mirabegron 50 mg , mirabegron 100 mg , and tolterodine ER 4 mg , respectively . Baseline demographic and OAB characteristics were similar across groups . TEAEs were reported in 59.7 % , 61.3 % , and 62.6 % of patients , respectively ; most were mild or moderate . Serious TEAEs were reported in 5.2 % , 6.2 % , and 5.4 % of patients , respectively . The most common TEAEs were similar across groups . Dry mouth was reported by 2.8 % , 2.3 % , and 8.6 % of patients , respectively . Adjusted mean changes from baseline to final visit in morning systolic blood pressure were 0.2 , 0.4 , and -0.5 mm Hg for mirabegron 50 mg , 100 mg , and tolterodine ER 4 mg , respectively . Mirabegron and the active control , tolterodine , improved key OAB symptoms from the first measured time point of 4 wk , and efficacy was maintained throughout the 12-mo treatment period . The study was not placebo controlled , which was a limitation . CONCLUSIONS The safety and tolerability of mirabegron was established over 1 yr , with sustained efficacy observed over this treatment period . TRIAL REGISTRATION Clinical Trials.gov identifier : NCT00688688
Pelvic floor exercises are more effective in subjective and objective outcomes with biofeedback or verbal feedback .
Weight loss with diet and exercise , caffeine reduction , 25 - 50 % reduction in fluid intake , and pelvic floor muscle exercises with verbal instruction and or biofeedback were all efficacious .
Botulinum toxin A improves urge incontinence episodes , urgency , frequency , quality of life , nocturia , and urodynamic testing parameters .
Acupuncture  improves quality of life and urodynamic testing parameters .
Extracorporeal magnetic stimulation improves urodynamic parameters .
Mirabegron improves daily incontinence episodes , nocturia , number of daily voids , and urine volume per void , whereas solabegron improves daily incontinence episodes .
Short-term posterior tibial nerve stimulation is more efficacious than pelvic floor muscle training exercises and behavioral therapy for improving : urgency , urinary incontinence episodes , daily voids , volume per void , and overall quality of life .
Sacral neuromodulation is more efficacious than antimuscarinic treatment for subjective improvement of overactive bladder and quality of life .
Transvaginal electrical stimulation demonstrates subjective improvement in overactive bladder symptoms and urodynamic parameters .
Multiple therapies , including physical therapy , behavioral therapy , botulinum toxin A , acupuncture , magnetic stimulation , mirabegron , posterior tibial nerve stimulation , sacral neuromodulation , and transvaginal electrical stimulation , are efficacious in the treatment of overactive bladder
The purpose of the study was to determine the efficacy and safety of nonantimuscarinic treatments for overactive bladder .