Roger Dmochowski, MD, on real-world persistence with vibegron for OAB

The real-world, phase 4 COMPOSUR study (NCT05067478) found that nearly 60% of patients taking vibegron remained on treatment at 1 year.¹ These data were presented at the 2025 American Urological Association (AUA) Annual Meeting in Las Vegas, Nevada.

In an interview with Urology Times®, lead author Roger R. Dmochowski, MD, MMHC, FACS, explained the background and key findings from the study and shared his thoughts on the implications of these findings for clinical practice.

“There's been a long history of concern regarding sustainability of long-term pharmacotherapy for patients for overactive bladder. The results, frankly, when you even look at 6 months, are quite abysmal in terms of patients retaining on prescribed therapy, like 30%,” he commented.

Data from the COMPOSUR study found that persistence with vibegron was 59.8% (95% CI, 54.7% to 64.6%) at 12 months. Among patients with prior anticholinergic medications, persistence was 61.3% (95% CI, 52.4% to 69%), and among those with prior mibegron, persistence was 59% (95% CI, 52.6% to 64.9%).

Dmochowski is a professor of urology and surgery at Vanderbilt University Medical Center in Nashville, Tennessee,

In total, the COMPOSUR study enrolled 403 patients, of whom 234 (58.1%) completed the trial. The primary reason for discontinuation was patient decision (62.1%).

To be eligible for enrollment, patients needed to be 18 years or older with OAB with or without urge urinary incontinence. They also needed to be starting a new course of vibegron and had previously received anticholinergics or mirabegron with or without anticholinergics.

Additional results from the study also showed that 69% of patients reported being consistently satisfied with treatment. The mean score of the OAB-SAT-q satisfaction domain was 65.6 (SD, 24.7). Treatment was also generally safe and well-tolerated. Overall, 36% of patients experienced a treatment-emergent adverse event (AE), and 2% of patients experienced a serious AE.

According to Dmochowski, these data can inform shared decision-making discussions with patients.

He noted, “Patients always have concerns, "Do I have to take medications all the time?", etc. This is one of the ways that we can actually give them some direct feedback.”

Dmochowski reports the following disclosures: Sumitomo Pharma America, Inc; Caldera Medical, Inc; Coloplast Corp; Medtronic, Inc; AbbVie Inc; Axonics, Inc; and others.

REFERENCE

1. Dmochowski RR, Rovner ES, Kennelly MJ, et al. Real-world outcomes of vibegron in patients with overactive bladder: Results from the phase 4 COMPOSUR study. J Urol. 2025;213(5S):e1030. doi:10.1097/01.JU.0001110076.71872.1a.14