Cardiovascular Risk in Users of Mirabegron Compared with Users of Antimuscarinic Treatments for Overactive Bladder: Findings from a Non-Interventional, Multinational, Cohort Study.

Autor: Hoffman V; Optum, 1325 Boylston Street, Boston, MA, 02215, USA., Hallas J; University of Southern Denmark, Odense, Denmark., Linder M; Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden., Margulis AV; RTI Health Solutions, Barcelona, Spain., Suehs BT; Humana Healthcare Research, Louisville, KY, USA., Arana A; RTI Health Solutions, Barcelona, Spain., Phiri K; Optum, 1325 Boylston Street, Boston, MA, 02215, USA., Enger C; Optum, 1325 Boylston Street, Boston, MA, 02215, USA., Horter L; Humana Healthcare Research, Louisville, KY, USA., Odsbu I; Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden., Olesen M; University of Southern Denmark, Odense, Denmark., Perez-Gutthann S; RTI Health Solutions, Barcelona, Spain., Xu Y; Humana Healthcare Research, Louisville, KY, USA., Kristiansen NS; University of Southern Denmark, Odense, Denmark., Appenteng K; Astellas Pharma US, Chicago, IL, USA., de Vogel S; Astellas Pharma Europe B.V., Leiden, The Netherlands., Seeger JD; Optum, 1325 Boylston Street, Boston, MA, 02215, USA. John.Seeger@optum.com.
Jazyk: angličtina
Zdroj: Drug safety [Drug Saf] 2021 Aug; Vol. 44 (8), pp. 899-915. Date of Electronic Publication: 2021 Jul 08.
DOI: 10.1007/s40264-021-01095-7
Abstrakt: Introduction: During clinical trials, mirabegron, a β3-adrenoreceptor agonist, was associated with increased vital signs vs placebo in patients with overactive bladder.
Objective: The purpose of this study was to compare incidence rates of adverse cardiovascular (CV) outcomes following mirabegron or antimuscarinic use.
Methods: We conducted an observational post-marketing safety study utilising real-world data. The study population was identified within five sources: Danish and Swedish National Registers, Clinical Practice Research Datalink (UK), Optum (USA) and Humana (USA). Episodes of time when patients were new users of mirabegron or antimuscarinics (October 2012-December 2018) were sourced from prescriptions and matched on propensity scores. Occurrences of major adverse cardiovascular events (MACE), acute myocardial infarction (AMI), stroke, CV mortality and all-cause mortality were identified. Outcome incidence rates and hazard ratios from Cox models were estimated.
Results: Overall, 152,026 mirabegron and 152,026 antimuscarinic episodes were matched. The population consisted of 63.1% women and 72.6% were ≥ 65 years old. There were no appreciable differences in the incidence rates of MACE, AMI or stroke between users of mirabegron and antimuscarinics. Incidence rates of CV mortality (hazard ratio 0.83, 95% confidence interval 0.73-0.95) and all-cause mortality (hazard ratio 0.80, 95% confidence interval 0.76-0.84) were no higher with mirabegron vs antimuscarinics. Results restricted to episodes at high risk for CV events or stratified by age (< 65 years, ≥ 65 years) or prior overactive bladder medication use were consistent with overall findings.
Conclusions: This large, multinational study found no higher risk of MACE, AMI, stroke, CV mortality or all-cause mortality among users of mirabegron relative to users of antimuscarinics.
(© 2021. The Author(s).)
Databáze: MEDLINE
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