Comparison of Mirabegron and Solifenacin for the Management of Urge Incontinence in Menopausal Age Group

Objective: To compare efficacy and tolerability of Mirabegron and Solifinacin in urge incontinence in menopausal women. Methodology: This RCT was conducted in the Maternal and Child Health (MCH) Center, Unit II, Pakistan Institute of Medical Sciences (PIMS), SZABMU (Shaheed Zulfiqar Ali Bhutto Medical University), Islamabad in two years from December 2020 to January 2022. A total of 63 patients each were randomized to receive Mirabegron (Group-A) or Solifinacin (Group B). Primary outcome was efficacy which was assessed by micturations per 24 hours, urge episodes, urges in incontinence and nocturia. The final outcome was measured on 3-month-follow-up. Results: The mean age was 48.0 ± 5.2 years in Mirabegron and 50.7 ± 6.1 years in Solifinacin group. In Solifinacin group 4 (6.3%) patients still experienced urine leak compared to none (0.0%) in Mirabegron group (p-value, 0.04). The rate of night urination and micturition also found greater in the Solifinacin group. The number of protective garments used per day was significantly greater in the Solifinacin group (p-value, 0.001). After 3 months of therapy, more patients from Solifinacin group experienced drowsiness as sedation, and constipation than those in Mirabegron group (p- value, <0.001). Few cases were experiencing confusion/delirium, palpitations in Solifinacin group (p-value, 0.04) as noted on 3 month follow-up. Conclusion: Mirabegron is better than Solifinacin in the management of urge incontinence in older women. Mirabegron was also found more tolerable.