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Research Letter
July 15, 2019

Association of Mirabegron With the Risk of Arrhythmia in Adult Patients 66 Years or Older—A Population-Based Cohort Study

Author Affiliations
  • 1Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
  • 2Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada
  • 3Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
  • 4Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
  • 5Division of Urology, University of Toronto, Toronto, Ontario, Canada
  • 6Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
  • 7Sunnybrook Research Institute, Toronto, Ontario, Canada
  • 8Li Ka Shing Centre for Healthcare Analytics Research and Training, St Michael’s Hospital, Toronto, Ontario, Canada
JAMA Intern Med. Published online July 15, 2019. doi:10.1001/jamainternmed.2019.2011

Recently, mirabegron, the first β3-adrenoceptor agonist, has been prescribed to treat overactive bladder (OAB) more frequently than antimuscarinic agents.1 The β-3 agonist medications have limited adverse effects compared with antimuscarinic agents.2,3 However, β3-adrenoreceptors are associated with increases in contractile force and reductions in inotropic effects,4 actions which raise concerns of cardiovascular (CV) adverse effects. These adverse effects have been reinforced by trials, finding a small increase in heart rate, blood pressure, and QTc intervals.2-4 Real-world data among older patients with CV comorbidities are lacking.5 We conducted a population-based cohort study to evaluate the risk of cardiac arrhythmias and other CV events in a population of patients 66 years and older receiving mirabegron.

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