{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T08:01:57Z","timestamp":1777104117569,"version":"3.51.4"},"reference-count":16,"publisher":"Wiley","license":[{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To summarize current evidence on \u03b23\u2010adrenoceptor agonists for managing neurogenic lower urinary tract dysfunction (NLUTD), focusing on their efficacy, safety, and clinical role in optimizing bladder storage and protecting upper tracts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Evidence from randomized controlled trials, meta\u2010analyses, and observational studies in spinal cord injury (SCI), multiple sclerosis (MS), and spina bifida populations was reviewed. Outcomes included bladder storage parameters, patient\u2010reported measures, and cardiovascular and cognitive safety profiles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\u03b23\u2010adrenoceptor agonists such as Mirabegron improve cystometric capacity, reduce detrusor pressure, and enhance quality of life. A recent individual\u2010patient meta\u2010analysis confirmed these benefits. Early data on Vibegron in SCI and spina bifida show increased bladder compliance and capacity without new safety concerns. Cardiovascular safety signals are reassuring: one randomized trial in SCI\/MS and a large multinational cohort both showed no excess risk. Observational studies continue to associate antimuscarinics with cognitive adverse effects, whereas \u03b23\u2010agonists demonstrate a more favorable tolerability profile.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\u03b23\u2010adrenoceptor agonists represent a safe, effective, and well\u2010tolerated first\u2010line option in NLUTD management. They preserve bladder safety and continence with fewer systemic side effects. OnabotulinumtoxinA remains an important escalation therapy for refractory cases but carries higher procedural and retention risks. A \u03b23\u2010agonist\u2013based strategy offers a rational, patient\u2010centered foundation for treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nau.70175","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T11:17:07Z","timestamp":1762427827000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["\u03b23\u2010Adrenoceptor Agonists for Neurogenic Lower Urinary Tract Dysfunction: Evidence and Clinical Rationale for First\u2010Line Therapy"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4969-8118","authenticated-orcid":false,"given":"Sharon E.","family":"Fishberg","sequence":"first","affiliation":[{"name":"Department of Surgery Sunnybrook Health Sciences Centre, Division of Urology University of Toronto Toronto Ontario Canada"},{"name":"Sunnybrook Health Sciences Center, Division of Urology Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1414-4991","authenticated-orcid":false,"given":"Rano","family":"Matta","sequence":"additional","affiliation":[{"name":"Department of Surgery Sunnybrook Health Sciences Centre, Division of Urology University of Toronto Toronto Ontario Canada"},{"name":"Sunnybrook Health Sciences Center, Division of Urology Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,6]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.23566"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.23774"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.25439"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41393-021-00748-1"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.14692"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.70136"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40264-021-01095-7"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2019.2011"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjmed-2023-000799"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2024.02.002"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2021.10.009"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.7663"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000002235"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.5489\/cuaj.5912"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000032377"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/toxins16080343"}],"container-title":["Neurourology and Urodynamics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.70175","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T11:17:08Z","timestamp":1762427828000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/nau.70175"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,6]]},"references-count":16,"alternative-id":["10.1002\/nau.70175"],"URL":"https:\/\/doi.org\/10.1002\/nau.70175","archive":["Portico"],"relation":{},"ISSN":["0733-2467","1520-6777"],"issn-type":[{"value":"0733-2467","type":"print"},{"value":"1520-6777","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,6]]},"assertion":[{"value":"2025-10-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"nau.70175"}}