(192) Real-world characteristics of patients with overactive bladder initiating vibegron or mirabegron

Background: : Real-world comparison of the characteristics of patients with overactive bladder (OAB) initiating vibegron or mirabegron is limited.

Objective: : Compare baseline characteristics of patients with OAB initiating vibegron vs mirabegron.

Methods: : This retrospective cohort analysis used the IQVIA PharMetrics® Plus Closed Health Plan Claims database to identify adults with OAB with ≥2 prescription fills for vibegron or mirabegron from January 2016 to May 2024, and no use of either in the past 6 months. The index date was the first dispense date of vibegron or mirabegron (April 2021 to February 2024). Patients had ≥6 months of preindex and ≥2 months of postindex continuous medical and pharmacy benefits. Demographics were assessed at index. Comorbidities were extracted using all available baseline medical claims. Procedure, medication, and healthcare resource utilization (HCRU) were assessed during the 183-day preindex period. HCRU was normalized to per-person-per-year (PPPY). Standardized mean differences (SMD) were used to compare patient characteristics.

Results: : In total, 40,729 patients (vibegron cohort, n=6490; mirabegron cohort, n= 34,239) were identified. Patient cohort entry occurred later for vibegron vs mirabegron. Mean age of new vibegron (vs mirabegron) users was 63.4 years (vs 62.6 years). Among patients initiating vibegron vs mirabegron, 29.7% vs 26.9% were males, and among those, 23.4% vs 20.5% had evidence of benign prostatic hyperplasia, respectively. Preindex, more patients with OAB initiating treatment (vibegron vs mirabegron; SMD) had: diagnosis of arrhythmia (27.5% vs 23.3%; 0.1), hypertension (71.5% vs 66.7%; 0.1), and stress incontinence (19.0% vs 14.0%; 0.1); undergone cystoscopy (11.5% vs 8.5%; 0.1), urinalysis (69.0% vs 56.3%; 0.3), post-void residual volume (38.0% vs 22.2%; 0.4), and urodynamics procedures (8.7% vs 5.6%; 0.1). Prior medications for vibegron (vs mirabegron) users were: OAB anticholinergics (33.1% vs 31.8%), alpha blockers (15.8% vs 15.6%), CYP2D6 substrates (72.9% vs 72.1%), beta blockers (29.6% vs 25.0%), and antiarrhythmics (7.2% vs 5.1%). Mean ± SD preindex HCRU and costs were higher for vibegron vs mirabegron initiators: PPPY outpatient visits (32.9 ± 26.8 vs 28.7 ± 25.1), pharmacy encounters (53.9 ± 49.0 vs 47.7 ± 44.0) , and total costs ($26,919.55 ± $58,200.49 vs $25,770.65 ± $68,748.20), respectively.

Conclusions: : This analysis showed clinically meaningful differences in baseline characteristics of patients with OAB initiating vibegron vs mirabegron. Patients initiating vibegron had a more complex clinical history.

Sponsorship:: Sumitomo Pharma America, Inc.