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World J Urol ; 39(8): 3049-3056, 2021 Aug.
Article in English | MEDLINE | ID: mdl-33386947

ABSTRACT

INTRODUCTION AND OBJECTIVE: Multiple sclerosis (MS) is the most frequent autoimmune demyelinating disease of the central nervous system. MS patients usually present with lower urinary tract dysfunction (LUTD). Objective of this study is to evaluate and compare the efficacy and safety of treating MS patients with LUTD with either a b3 agonist (mirabegron) or anticholinergics. The study's primary outcome is the LUTD symptom improvement. MATERIAL AND METHODS: This is a multi-center, single-blinded, comparative study including 91 MS patients with LUTD. At baseline, patients underwent thorough clinical examination, urine cultivation and abdominal ultrasound and completed urination diaries and specific, validated questionnaires (NBSS, MusiQoL). At second visit, patients were administered either mirabegron or anticholinergics. Treatment was always carried out alongside with MS treatment. Reevaluation was performed 3 months after first visit. Patients underwent the same clinical and imaging tests that were carried out at first visit. RESULTS: We compared several clinical and imaging parameters between the two groups at first visit and month 3 after treatment. Νo statistical difference was noted between the mirabegron group and the anticholinergic group in terms of LUTD improvement. In both groups, improvement from baseline regarding LUTD was recorded. Statistical analysis was performed using the paired and unpaired t test method. No patient discontinued either medication due to side effects. CONCLUSIONS: MS patients receiving either mirabegron or anticholinergic therapy for LUTD showed improvement. Nevertheless, no statistical difference was noted between the two cohorts at 3 months in terms of drug efficacy in all the statistically significant parameters.


Subject(s)
Acetanilides , Cholinergic Antagonists , Lower Urinary Tract Symptoms , Multiple Sclerosis , Thiazoles , Acetanilides/administration & dosage , Acetanilides/adverse effects , Adrenergic beta-3 Receptor Agonists/administration & dosage , Adrenergic beta-3 Receptor Agonists/adverse effects , Cholinergic Antagonists/administration & dosage , Cholinergic Antagonists/adverse effects , Drug Monitoring/methods , Drug Monitoring/statistics & numerical data , Female , Humans , Lower Urinary Tract Symptoms/diagnosis , Lower Urinary Tract Symptoms/drug therapy , Lower Urinary Tract Symptoms/etiology , Male , Middle Aged , Multiple Sclerosis/diagnosis , Multiple Sclerosis/drug therapy , Multiple Sclerosis/physiopathology , Single-Blind Method , Symptom Assessment/methods , Thiazoles/administration & dosage , Thiazoles/adverse effects , Treatment Outcome , Ultrasonography/methods
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