Evidence map›Paper›PMID 26908514›Full record

ArticleBMJ open2016

Comparative assessment of onabotulinumtoxinA and mirabegron for overactive bladder: an indirect treatment comparison.

Nick Freemantle, David A Ginsberg, Rachael McCool, Kelly Fleetwood, Mick Arber, Kristin Khalaf, Clara Loveman, Quanhong Ni, Julie Glanville

Abstract readComparative StudyNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Guideline
  2. Pooled it
  3. Article
  4. Article
  5. Intravesicular Onabotulinumtoxin A Hemorrhage on Rivaroxaban.Case reports in obstetrics and gynecology · 2019
    Article
  6. Review
  7. Urinary incontinence in women.Nature reviews. Disease primers · 2017
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Nick FreemantleDepartment of Primary Care and Population Health, University College London, London, UK.
David A GinsbergUSC Institute of Urology, Keck School of Medicine of USC, Los Angeles, California, USA.
Rachael McCoolYork Health Economics Consortium, University of York, York, UK.
Kelly FleetwoodQuantics, Edinburgh, UK.
Mick ArberYork Health Economics Consortium, University of York, York, UK.
Kristin KhalafAllergan, Inc., Irvine, California, USA Xcenda, Palm Harbor, Florida, USA.
Clara LovemanAllergan Holdings Ltd, Marlow, UK.
Quanhong NiAllergan, Inc., Bridgewater, New Jersey, USA Celgene, Summit, New Jersey, USA.
Julie GlanvilleYork Health Economics Consortium, University of York, York, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

contextOnabotulinumtoxinA and mirabegron have recently gained marketing authorisation to treat symptoms of overactive bladder (OAB).

objectiveTo evaluate the relative efficacy of mirabegron and onabotulinumtoxinA in patients with idiopathic OAB.

designNetwork meta-analysis. DATA SOURCES: A search of 9 electronic databases, review documents, guidelines and websites.

methodsRandomised trials comparing any licensed dose of onabotulinumtoxinA or mirabegron with each other, anticholinergic drugs or placebo were eligible (19 randomised trials were identified). 1 reviewer extracted data from the studies and a second reviewer checked the data. Candidate trials were assessed for similarity and networks were developed for each outcome. Bayesian network meta-analysis was conducted using both fixed-effects and random-effects models. When there were differences in mean baseline values between mirabegron and onabotulinumtoxinA trials they were adjusted for using network meta-regression (NMR).

resultsNo studies directly comparing onabotulinumtoxinA to mirabegron were identified. A network was created for each of the 7 outcomes, with 3-9 studies included in each individual network. The trials included in the networks were broadly similar. Patients in the onabotulinumtoxinA trials had more urinary incontinence and urgency episodes at baseline than patients in the mirabegron trials and these differences were adjusted for using NMR. Both onabotulinumtoxinA and mirabegron were more efficacious than placebo at reducing the frequency of urinary incontinence, urgency, urination and nocturia. OnabotulinumtoxinA was more efficacious than mirabegron (50 and 25 mg) in completely resolving daily episodes of urinary incontinence and urgency and in reducing the frequency of urinary incontinence, urgency and urination. NMR supported the results of the network meta-analysis.

conclusionsIn the absence of head-to-head trials comparing onabotulinumtoxinA to mirabegron, this indirect comparison indicates that onabotulinumtoxinA may be superior to mirabegron in improving symptoms of urinary incontinence, urgency and urinary frequency in patients with idiopathic OAB.

Indexed as

AcetanilidesBotulinum Toxins, Type AHumansNocturiaThiazolesUrinary Bladder, OveractiveUrinary IncontinenceUrinationUrological AgentsAcetanilidesBotulinum Toxins, Type AmirabegronThiazolesUrological Agents

Identifiers

PMID26908514
PMCPMC4769403

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.