Vibegron for BPH Patients with Persistent Overactive Bladder Symptoms


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David Staskin discusses the COURAGE trial, a phase three study evaluating the efficacy of Vibegron, a beta-3 adrenergic receptor agonist, in men with BPH and persistent OAB symptoms despite alpha-blocker treatment. The study demonstrates significant improvements in various urinary symptoms, including micturitions, urgency episodes, and nocturia. Dr. Staskin highlights the drug's favorable safety profile, particularly noting the lack of increased urinary retention risk. The discussion explores the potential for using beta-3 agonists in different patient populations, including those with predominant OAB symptoms or post-operative cases. Drs. Crawford and Staskin emphasize the importance of this data for both urologists and primary care physicians in managing patients with persistent OAB symptoms. They also touch on the potential for expanding Vibegron's FDA-approved indications and the need to disseminate this information to family practice doctors who often treat these patients.

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A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

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Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

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The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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