Cardiovascular safety of vibegron, a new β3‐adrenoceptor agonist, in older patients with overactive bladder: Post‐hoc analysis of a randomized, placebo‐controlled, double‐blind comparative phase 3 study

• Published in: Neurourology and urodynamics Vol. 40; no. 6; pp. 1651 - 1660
• Main Authors: Yoshida, Masaki, Takeda, Masayuki, Gotoh, Momokazu, Yokoyama, Osamu, Kakizaki, Hidehiro, Takahashi, Satoru, Masumori, Naoya, Nagai, Shinji, Minemura, Kazuyoshi
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.08.2021; John Wiley and Sons Inc
• Subjects: Adrenergic beta-3 Receptor Agonists - adverse effects; Adrenergic receptors; Adverse events; Aged; aging; Agonists; Blood pressure; Cardiovascular System; Double-Blind Method; Double-blind studies; Humans; Middle Aged; Muscarinic Antagonists; Original Clinical; Patients; pharmacological therapy; Placebos; Pyrimidinones; Pyrrolidines; Receptors, Adrenergic; Safety; subgroup; Treatment Outcome; Urinary Bladder, Overactive - drug therapy; Urinary incontinence; urinary symptom; urinary urgency; Urination; pharmacological therapy; subgroup; aging; urinary urgency; urinary symptom
• ISSN: 0733-2467; 1520-6777; 1520-6777
• DOI: 10.1002/nau.24732

Aims To examine the safety and efficacy of vibegron, a new β3‐adrenoceptor agonist, in patients aged ≥65 years, with a focus on the effects on cardiovascular system and overactive bladder (OAB) symptoms. Methods A post‐hoc subgroup analysis was performed of a randomized, placebo‐controlled, double‐blind comparative phase 3 study of vibegron, including those assigned to receive either vibegron 50 mg (V50), vibegron 100 mg (V100), or placebo for 12 weeks. Subjects were stratified into two subgroups based on age: a <65‐year subgroup and a ≥65‐year subgroup. Safety (changes in systolic and diastolic blood pressure, pulse rate, and residual urine volume) and efficacy (changes in the numbers of micturitions, urgency episodes, urgency urinary incontinence [UUI] episodes, and the voided volume/micturition) were assessed in the subgroups treated with vibegron vs. placebo. Results There were no significant differences in the cardiovascular outcomes (blood pressure and pulse rate), nor in the changes in residual urine volume, between the V50/100 and placebo groups in the <65‐year or ≥65‐year subgroup after 12‐week treatment. Adverse events were slightly increased in the ≥65‐year subgroup. In the efficacy analysis, V50/100 demonstrated similar efficacy in the <65‐year and ≥65‐year subgroups; an increasing trend in the voided volume/micturition was observed in subjects aged ≥65 years compared to subjects aged <65 years. Conclusions Vibegron was suggested to be similarly effective in patients ≥65 and <65 years and to have minimal influence on cardiovascular parameters.