Real-World Adherence and Persistence of Vibegron Versus Mirabegron and Anticholinergics in Patients With Overactive Bladder: A Retrospective Claims Analysis.

Introduction: Overactive bladder (OAB) management with pharmacotherapy is limited by low real-world adherence and persistence. This analysis compared real-world adherence and persistence of patients initiating vibegron, a 3-adrenergic receptor agonist approved in December 2020 for OAB, with mirabegron and anticholinergics. Methods: This retrospective study used pharmacy claims data from the Optum Research Database. Study criteria included patients ≥18 years old with ≥1 pharmacy claim for vibegron, mirabegron, or anticholinergic from April 1, 2021--December 31, 2021; continuous enrollment in a health plan with pharmacy and medical benefits for 3 months preindex (baseline) and ≥2 months postindex (follow-up); and no index medication during baseline. Two independent propensity-score models were used to match patients treated with (1) vibegron vs mirabegron and (2) vibegron vs anticholinergics. Adherence was measured by proportion of days covered (PDC) from index to end of follow-up and defined as PDC ≥80%. Persistence was defined as days to discontinuation of index medication or end of follow-up. Adherence and persistence were analyzed descriptively and by Kaplan-Meier analysis, respectively. Results: The matched vibegron and mirabegron cohorts included 1655 and 3310 patients, respectively; the matched vibegron and anticholinergic cohorts included 1595 and 3190 patients. Patients receiving vibegron had greater adherence vs patients receiving mirabegron (PDC=0.71 vs 0.68, respectively; P=0.004) or anticholinergics (0.71 vs 0.61; P<0.001). A greater percentage of patients receiving vibegron were adherent (ie, PDC ≥80%) vs those receiving mirabegron (53.4% vs 49.2%, respectively; P=0.005) or anticholinergics (53.7% vs 43.2%; P<0.001). Persistence was longer with vibegron vs mirabegron (median [95% CI]; 205 [162-246] vs 148 [126-162] days, respectively; P<0.001) and anticholinergics (207 [167-246] vs 91 [91- 95] days; P<0.001). Conclusions: In this retrospective analysis, real-world adherence and persistence was higher in patients initiating vibegron compared with patients initiating mirabegron or anticholinergic when matched on baseline characteristics. [ABSTRACT FROM AUTHOR]