Comparative Efficacy and Safety of Mirabegron and Vibegron in Female Patients With Overactive Bladder: A Systematic Review and Meta-analysis of Randomized Controlled Trials

OBJECTIVE To compare the efficacy and safety of mirabegron and vibegron in female patients with overMETHODS This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A meta-analysis of randomized controlled trials (RCTs) referred to the use of mirabegron and vibegron in female patients with OAB from PubMed, EMBASE, Cochrane Library, and Web of Science databases was performed. RESULTS Three RCTs involving 371 patients were included. We found that vibegron was more effective in relieving urgency urinary incontinence in females with OAB compared to mirabegron [mean difference (MD)=0.25, 95% confidence interval (CI) 0.04 to 0.47, p=0.02]. And vibegron was similar to mirabegron in OAB symptom score (OABSS) [MD=0.22, 95% CI -0.32 to 0.76, p=0.42], urgency (MD=0.15, 95% CI -0.08 to 0.38, p=0.20), quality of life (QOL) (MD=-0.18, 95% CI -0.49 to 0.13, p=0.26), mean volume voided per micturition (MD=-6.16, 95% CI -21.50 to -9.17, p=0.43). In terms of the safety outcomes, there were no significant differences between mirabegron and control groups in terms of the total adverse events (TAEs) [odds ratio (OR)=0.75; 95% CI: 0.44 to 1.26; p=0.28], dry mouth (OR=1.01; 95% CI: 0.36 to 2.81; p=0.99), constipation (OR=0.69; 95% CI: 0.33 to 1.44; p=0.32), elevated post-void residual (PVR) (OR=0.35; 95% CI: 0.05 to 2.23; p=0.26), and dizziness (OR=1.02; 95% CI: 0.14 to 7.31; p=0.98). CONCLUSION In female OAB patients, the efficacy and safety of mirabegron and vibegron were similar. Vibegron may be more effective than mirabegron in relieving urgency urinary incontinence. UROLOGY 199: 182-190, 2025. (c) 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.