Mirabegron and Intradetrusor Onabotulinumtoxina for Overactive Bladder in Parkinson's Disease: A Systematic Review and Meta-Analysis.
Hussain Arshad, Raiyana Nuha, Shehab Khashaba et al.
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In 30 seconds
This systematic review and meta-analysis synthesized randomized and observational evidence on mirabegron and intradetrusor onabotulinumtoxinA (BoNT-A), assessed separately, for overactive bladder in adults with idiopathic Parkinson’s disease. Eight single-arm pre–post studies were included; no head-to-head trials were identified. Pooled results showed reductions in 24-hour urinary frequency (MD -4.48; 95% CI -8.45 to -0.52) and incontinence (MD -1.24; 95% CI -1.98 to -0.50). Urgency did not show a statistically significant reduction. Evidence certainty was low to moderate.
Key findings
- Pooled change in 24-hour urinary frequency was MD -4.48; 95% CI -8.45 to -0.52.
- Pooled change in incontinence was MD -1.24; 95% CI -1.98 to -0.50; urgency change was MD -2.68; 95% CI -7.08 to 1.72.
- Mean postvoid residual increased by +43 mL with BoNT-A and changed by +3 mL with mirabegron.
- Mirabegron adverse events were generally mild; BoNT-A was associated with transient urinary retention and urinary tract infection.
Why it matters
Overactive bladder symptoms can affect people with Parkinson’s disease, and this review summarizes symptom and safety signals for two distinct interventions. The findings suggest possible reductions in several symptoms, but the absence of direct comparisons means they cannot establish which intervention is preferable. Low-to-moderate certainty and limited study designs warrant cautious interpretation.
What to keep in mind
Only eight single-arm pre–post studies were included, with no head-to-head trials. The authors report small samples, heterogeneity, short follow-up, and low-to-moderate certainty of evidence.