Combination treatment with vibegron and solifenacin for refractory non‐monosymptomatic enuresis
Abstract
We read with great interest the article by Uchihara et al.1 The authors, in their retrospective study of 29 children with refractory enuresis that was unresponsive to conventional treatments, demonstrated that vibegron, a novel selected β3-adrenoreceptor agonist, may provide a promising treatment by increasing bladder capacity. In 2020, we first reported vibegron as a useful treatment option for refractory monosymptomatic nocturnal enuresis (MNE), particularly in those with constipation.2 We revealed a significantly higher proportion of patients with refractory MNE who received combination treatment with vibegron and solifenacin in the response group than in the no-response group.3 However, the efficacy of the combination treatment for refractory non-monosymptomatic nocturnal enuresis (NMNE) remains unknown. Here, we report on the effects of vibegron treatment for 3 months as an add-on therapy in children with NMNE that is refractory to solifenacin—i.e., with persistent daytime urinary incontinence (DUI) after 3 months of solifenacin. This retrospective study enrolled 21 children with refractory NMNE (median age 7.4 years) at Saitama Children's Medical Center from January 2019 to September 2022. For children with NMNE, the first step was lifestyle guidance such as regular voiding habits and a good voiding posture, and solifenacin (2.5 mg for patients weighing <25 kg, or 5 mg for patients weighing ≥25 kg; Vesicare, tablet, Astellas Pharma Inc., Tokyo, Japan) was initiated…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 29 participants or records.
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