TOPLINE

Most children with neurogenic and nonneurogenic lower urinary tract dysfunction and related urologic or bowel conditions who received mirabegron experienced improvement in their symptoms, with generally mild side effects that resolved after stopping the drug.

METHODOLOGY

• Researchers retrospectively reviewed records to assess the safety and effectiveness of mirabegron in children with lower urinary tract dysfunction and related urologic or bowel conditions.
• They included 192 children (median age, 10.2 years; 53% girls) who were prescribed mirabegron between 2018 and 2024 at a single center in Canada.
• Children received daily oral mirabegron tablets, usually beginning at 25 mg, either alone or alongside other medications.
• Primary outcomes were side effects and changes in symptoms across four domains: daytime incontinence, urinary urgency, bedwetting at night, and urinary frequency. Symptom improvement was classified as none (< 50%), partial (50%-99%), or complete (100%).
• The median follow-up duration was 11.6 months.

TAKEAWAY

• Nonneurogenic lower urinary tract dysfunction was the most common indication for mirabegron (46%), followed by neurogenic bladder (42%).
• Adverse events occurred in 13% of children, most commonly headaches (4%), nausea (4%), and hypertension (2%); headaches and hypertension resolved after stopping mirabegron. One child with a seizure history was hospitalized for a seizure after starting the drug.
• Overall, 65% of children had at least partial improvement in symptoms, with a median time to improvement of 7 months. Among those with daytime incontinence, 53% achieved complete resolution at their last follow-up.
• Age, sex, neurogenic vs nonneurogenic bladder diagnosis, behavioral conditions, and use of anticholinergics or botulinum injections were not associated with improvement in symptoms.

IN PRACTICE

"The risk of serious side effects remains low, and likelihood of symptom improvement is sufficient to justify its use in pediatric care," the authors wrote.

SOURCE

The study was led by Adree Khondker, MD, of The Hospital for Sick Children in Toronto, Canada. It was published online on August 31 in the Journal of Pediatric Urology.

LIMITATIONS

Researchers could not always determine the precise timing of improvement of symptoms or onset of adverse events. The study lacked a control group. Several key variables were not consistently available.

DISCLOSURES

The authors did not report any funding source or conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.