Peyronnet Benoit, Brucker Benjamin M, De Nunzio Cosimo, Gratzke Christian, Heesakkers John, Michel Martin C, Serati Maurizio, Staskin David, Chapple Christopher
Department of Urology, Service dUrologie, Hopital Pontchaillou, University Hospital of Rennes, 2 Rue Henri Le Guilloux, 35000, Rennes, France.
Department of Urology and Obstetrics & Gynaecology, NYU Langone Health, New York, NY, USA.
World J Urol. 2025 Aug 26;43(1):514. doi: 10.1007/s00345-025-05799-8.
Overactive bladder (OAB) is a prevalent and potentially debilitating syndrome that significantly impairs quality of life. Mirabegron and vibegron are β-adrenoceptor (βAR) agonists that provide a different mechanism of action to antimuscarinic medications. Vibegron has high βAR selectivity and enhances detrusor relaxation without compromising voiding function. This review summarises the clinical and real-world evidence supporting the efficacy, safety and patient-reported benefits of vibegron in OAB.
A comprehensive search of the PubMed database was conducted in December 2024 using the keyword "vibegron". This search yielded 123 entries, which were subsequently screened by title for relevance to the objectives of this narrative review. All relevant articles identified through this process were included.
Pivotal phase III trials have demonstrated significant reductions in urgency, urinary frequency and urgency urinary incontinence with vibegron, with rapid onset of action and a more favourable tolerability profile than antimuscarinics. The benefits of vibegron were consistent across diverse patient populations, including older adults and those with concomitant benign prostatic hyperplasia. Real-world data further suggest that vibegron is associated with improved adherence and persistence compared with other OAB therapies. Additionally, cardiovascular safety studies confirm that vibegron has no clinically significant effects on blood pressure or heart rate. While comparative trials with mirabegron indicate similar efficacy, vibegron's higher βAR selectivity and lack of cytochrome P450 interactions offer advantages in specific patient groups. Ongoing research, including real-world phase IV studies, aims to further define the long-term effectiveness and safety of vibegron in clinical practice.
Vibegron represents an important advance in the pharmacologic management of OAB, providing a well-tolerated and effective alternative to existing therapies.
膀胱过度活动症（OAB）是一种常见且可能使人衰弱的综合征，会严重损害生活质量。米拉贝隆和维贝隆是β-肾上腺素能受体（βAR）激动剂，其作用机制与抗毒蕈碱药物不同。维贝隆具有较高的βAR选择性，可增强逼尿肌松弛而不影响排尿功能。本综述总结了支持维贝隆治疗OAB的疗效、安全性及患者报告获益的临床和真实世界证据。
2024年12月使用关键词“维贝隆”对PubMed数据库进行全面检索。该检索产生了123条记录，随后通过标题筛选其与本叙述性综述目标的相关性。纳入通过该过程确定的所有相关文章。
关键的III期试验已证明，维贝隆可显著减少尿急、尿频和急迫性尿失禁，起效迅速，耐受性比抗毒蕈碱药物更佳。维贝隆的益处适用于包括老年人和伴有良性前列腺增生症患者在内的不同患者群体。真实世界数据进一步表明，与其他OAB治疗方法相比，维贝隆与更好的依从性和持续性相关。此外，心血管安全性研究证实，维贝隆对血压或心率无临床显著影响。虽然与米拉贝隆的对比试验显示疗效相似，但维贝隆更高的βAR选择性和缺乏细胞色素P450相互作用在特定患者群体中具有优势。正在进行的研究，包括真实世界IV期研究，旨在进一步明确维贝隆在临床实践中的长期有效性和安全性。
维贝隆代表了OAB药物治疗的一项重要进展，为现有治疗提供了耐受性良好且有效的替代方案。
