Central   Journal of Urology and Research Cite this article: Abdelmoteleb H, Yassin M, Hashim H (2016) Long Term Follow Up of Mirabegron - A Real Life- Pragmatic Experience. J Urol Res 3(6): 1068. *Corresponding author Ha itha m Ab d e lmo te le b , Bristo l Uro lo g ic a l Institute , So uth m e a d Ho sp ita l, G re a t We ste rn Ho sp ita l, Sw ind o n, SN3 6BB, UK, Te l: 440-7884-827995; Ema il: Submitte d: 04 June 2016 Accepted: 22 August 2016 Publishe d: 24 August 2016 ISSN: 2379-951X Copyright © 2016 Ab d e lmo te le b e t a l. OPEN ACCESS Ke ywo rds • Mira b e g ro n • Be ta -3 a g o nist • O ve ra c tive b la d d e r synd ro m e • Lo ng te rm Research Article Long Term Follow Up of Mirabegron - A Real Life- Pragmatic Experience Haitham Abdelmoteleb*, Musaab Yassin, and Hashim Hashim Bristol Urological Institute, South mead Hospital, UK Abstract Objectives: To evaluate the eficacy and tolerability of Mirabegron for the treatment of overactive bladder symptoms in a real life, long term follow up study conducted in a tertiary referral centre. Methods: A structured telephone questionnaire of patients was conducted in order to evaluate the eficacy and tolerability of Mirabegron. Patients who were initially prescribed and responded to Mirabegron 50mg once daily between 6/2013 and 9/2013, were interviewed to see if they were compliant with treatment, continue to respond to treatment and if they discontinued treatment. Results: Follow-up was for a mean of 11.7 months. At short-term follow-up, 20/39 patients responded to treatment. In the long term follow-up, 18/20 patients were still using Mirabegron. 2/20 patients discontinued because of lack of eficacy. Overall, the main reasons for discontinuation of Mirabegron after trying it for a mean of 5.3 months, was lack of eficacy and adverse events. The majority of AEs were mild in severity and few were serious. Other reasons include the lack of further prescription from general practitioners. Conclusion: Mirabegron is an eficacious new treatment for OAB with a favorable tolerability proile over 1-year period. The treatment led to a noticeable improvement in patients’ symptoms. The incidence of AEs was low; the majority was mild in severity and few were serious. ABBREVIATIONS OAB: Overactive bladder; UTI: Urinary Tract Infections; LUTS: Lower Urinary Tract Symptom; ICS: International Continence Society; AEs: adverse events; cAMP: cyclic Adenosine Monophosphate; NICEHTA: National Institute for Health and Clinical Excellence Health Technology Assessment; CTCAE: Common Terminology Criteria For Adverse Events; MMSE: Mini- Mental State Examination INTRODUCTION Overactive bladder (OAB) is defined as a condition with characteristic symptoms of urinary urgency, with or without urgency incontinence, usually accompanied by frequency and nocturia, in the absence of urinary tract infection s (UTI) or other obvious pathology [1]. Using the standardized International Continence Society (ICS) definition of OAB, the EPIC study reported the prevalence of OAB in four European countries and Canada, as 11.8%, in the context of a prevalence of 64.3% for at least one lower urinary tract symptom (LUTS) [2]. Initial treatment of OAB involves life style interventions such as avoidance of dietary irritants and cessation of smoking, bladder training and pelvic floor muscle exercises followed by medications. Antimuscarinic agents have become the most widely used pharmacologic agents for the treatment of OAB symptoms. These agents elicit their effects by blocking muscarinic M2 and M3 receptors, thereby inhibiting involuntary detrusor contractions. However, because detrusor contractions are also required for voluntary voiding, antimuscarinic agents have the potential to impair bladder emptying and may even cause urinary retention, particularly where there is coexisting bladder outlet obstruction [3]. Other common and bothersome adverse events (AEs) associated with antimuscarinics are dry mouth, constipation, dry or itchy eyes, blurred vision and UTIs [4]. In a considerable proportion of OAB patients, such side effects are sufficiently detrimental to quality of life that patients choose to discontinue treatment. Hence, these agents are associated with poor treatment compliance. The discontinuation rate is about 24.5%. The most commonly reported reason for discontinuing antimuscarinic agents was lack of efficacy (46.2%), followed by switching to a new medication (25.1%), patients managed to