Initial experience with vibegron for the treatment of neurogenic lower urinary tract storage dysfunction in patients with spinal cord injury

Introduction:: The objective of this study was to investigate the efficacy of the β3-adrenoreceptor agonist vibegron for the treatment of neurogenic lower urinary tract storage dysfunction in patients with spinal cord injury (SCI). Materials and Methods:: Twenty-three SCI patients treated with vibegron (50 mg/day) for at least 28 days were included in the study. All patients had urinary management with clean intermittent catheterization, and suffered from urinary incontinence (UI) associated with neurogenic detrusor overactivity (NDO) diagnosed with cystometrogram (CMG). Subjective symptoms and objective parameters were retrospectively evaluated before and after treatment with vibegron, using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and CMG parameters, respectively. Results:: ICIQ-SF scores for the frequency, amount, and overall impact of UI, as well as the total score, were statistically significantly improved after treatment with vibegron. In terms of objective parameters, maximum detrusor pressure during storage phase statistically significantly decreased with vibegron treatment (53.0 vs 23.0 cmH2O, P<0.001). In addition, maximum cystometric capacity (291 vs 401 ml, P<0.001), bladder volume at first NDO (160 vs 270 ml, P=0.002), and bladder compliance (7.2 vs 25.4 ml/cmH2O, P<0.001) all statistically significantly improved after treatment with vibegron. Conclusion:: Vibegron improved UI symptoms and CMG parameters in SCI patients. These results suggest that vibegron would be an efficacious treatment option for neurogenic lower urinary tract storage dysfunction in patients with SCI.