Solifenacin Versus Mirabegron: A Clinical Comparison in Overactive Bladder Treatment
DOI:
https://doi.org/10.62497/irjm.227Keywords:
Mirabegron, Urinary urgency, Overactive bladder, Urinary incontinence, Randomized controlled trialAbstract
Background: Overactive bladder (OAB) is a common chronic condition characterized by urinary urgency, usually accompanied by increased daytime frequency, nocturia, and, in some patients, urgency urinary incontinence. Pharmacological management primarily includes antimuscarinic agents and β3-adrenoceptor agonists; however, comparative evidence regarding their clinical effectiveness remains limited.
Objective: To compare the efficacy of solifenacin and mirabegron in the treatment of patients with overactive bladder.
Materials and Methods: This randomized controlled trial was conducted in the Department of Urology, Ayub Teaching Hospital, Abbottabad, Pakistan, from 23 July 2023 to 23 January 2024. A total of 254 patients diagnosed with OAB were randomized in a 1:1 ratio to receive either solifenacin 5 mg/day (Group A, n=127) or mirabegron 25 mg/day (Group B, n=127) for four weeks. Baseline demographic and clinical characteristics were recorded. Treatment efficacy was assessed by changes in urinary frequency, urinary incontinence episodes, and Patient Perception of Bladder Condition (PPBC) score. Between-group comparisons were performed using independent-samples t-tests.
Results: A total of 254 participants completed the study. Baseline characteristics were generally comparable between groups. Mirabegron demonstrated a significantly greater reduction in urinary frequency compared with solifenacin (2.34 ± 1.33 vs. 2.00 ± 0.87 episodes/day; t = -2.672, p = 0.005). Although reductions in urinary incontinence episodes were observed in both groups, the between-group difference was not statistically significant (1.96 ± 1.58 vs. 1.81 ± 0.52; t = -1.017, p = 0.310). Similarly, both treatments improved PPBC scores, with no significant difference between groups (-1.51 ± 0.96 vs. -1.65 ± 0.86; t = -1.172, p = 0.242).
Conclusion: Both solifenacin and mirabegron were effective in improving symptoms of overactive bladder. However, mirabegron was associated with a significantly greater reduction in urinary frequency, while both agents demonstrated comparable efficacy in reducing urinary incontinence episodes and improving patient-perceived bladder condition. These findings support mirabegron as an effective therapeutic option, particularly in patients with predominant urinary frequency symptoms.
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Copyright (c) 2026 Jawad Khan , Umair Ali, Safa Gul, Inam ullah, Abdullah Sahibzada, Ghanwa Imran, Abdul Majid, Tayyaba Batool, Wadiha Shah , Ruqiya Sania (Author)
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