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.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Tadrous M, Matta R, Greaves S, et al. Association of Mirabegron With the Risk of Arrhythmia in Adult Patients 66 Years or Older—A Population-Based Cohort Study. JAMA Intern Med. Published online July 15, 2019. doi:10.1001/jamainternmed.2019.2011
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: