Mirabegron in patients with age-related macular degeneration treated for overactive bladder: a study protocol for a prospective observational non-randomized trial

Although anti-vascular endothelial growth factor drugs have revolutionized the treatment of neovascular age-related macular degeneration (wet AMD), preventing eyes from converting from dry to wet AMD provides better long-term prognosis for sight and overall health. Mirabegron, an agonist at beta 3 adrenoceptors (β3-ARs), is licensed for the treatment of overactive bladder (OAB), but has potential effects on angiogenic proliferation in the retina, and therefore may reduce risk of conversion from dry to wet AMD. Both OAB and AMD are more common in older adults and share risk factors suggesting a potential link between these two conditions, thus highlighting the need for common therapy for the two diseases. Mirabegron use in AMD patients is supported by its rather safe profile at the eye level as macular and choriocapillary parameters do not seem to be affected in OAB patients. The purpose of this study will be to investigate the effects of mirabegron in patients concomitantly affected by OAB and dry AMD to evaluate its impact on slowing down AMD progression from the dry to the neovascular form. Clinical trial registration: https://clinicaltrials.gov/study/NCT07305298, identifier NCT07305298.