MP01-12 PHARMACOTHERAPY VS MINIMALLY INVASIVE THERAPIES AS INITIAL THERAPY FOR PATIENTS WITH BENIGN PROSTATE HYPERPLASIA: A MICROSIMULATION MODEL

Abstract

You have accessJournal of UrologyCME1 May 2022MP01-12 PHARMACOTHERAPY VS MINIMALLY INVASIVE THERAPIES AS INITIAL THERAPY FOR PATIENTS WITH BENIGN PROSTATE HYPERPLASIA: A MICROSIMULATION MODEL Yeva Sahakyan, Aysegul Erman, Naeem Bhojani, Bilal Chughtai, Kevin C. Zorn, Beate Sander, and Dean Elterman Yeva SahakyanYeva Sahakyan More articles by this author , Aysegul ErmanAysegul Erman More articles by this author , Naeem BhojaniNaeem Bhojani More articles by this author , Bilal ChughtaiBilal Chughtai More articles by this author , Kevin C. ZornKevin C. Zorn More articles by this author , Beate SanderBeate Sander More articles by this author , and Dean EltermanDean Elterman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002513.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: This study evaluated the effectiveness of MITs (Rezum and Urolift) compared to pharmacotherapy as initial treatment option for patients with moderate-to-severe BPH. METHODS: We developed a simulation model (image_a) to estimate the impact of Rezum and Urolift compared to pharmacotherapy as initial treatment on International Prostate Symptom Score (IPSS) progression, retreatment rates and quality-adjusted life years (QALYs), discounted at a 1.5% rate. We simulated males with a mean age of 65 years and an average IPSS of 16 over their lifetime. BPH progression and treatments effects were modeled through the IPSS score. Patients could receive up to two additional lines of therapy: i) patients who started with pharmacotherapy could receive MIT as a second-line, and TURP or pharmacotherapy as a third-line of therapy; ii) patients who started with MIT (Rezum or UroLift) could receive repeated MIT or TURP or pharmacotherapy as a second-line, and TURP as a third line of therapy. Therapy-specific adverse events were applied. The model was informed by data from the published literature. RESULTS: Simulated health outcomes compared well to the reported trials data (image_b). Over 20 years the proportion of patients who were retreatment free were 49% for Rezum, 39% for Urolift and 50% for pharmacotherapy. Over the patients’ lifetime initial treatment with Rezum was the most effective option (15.18 QALYs), pharmacotherapy followed by Rezum was the second most effective option (15.08 QALY), followed by Urolift (14.99 QALYs) as initial treatment, and, lastly, pharmacotherapy followed by UroLift (14.98 QALY). CONCLUSIONS: MITs are effective treatment options for moderate-to-severe BPH. These findings will be beneficial for clinicians and health policy makers to further define the implementation of MITs in treatment for BPH. Source of Funding: Not applicable © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e5 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yeva Sahakyan More articles by this author Aysegul Erman More articles by this author Naeem Bhojani More articles by this author Bilal Chughtai More articles by this author Kevin C. Zorn More articles by this author Beate Sander More articles by this author Dean Elterman More articles by this author Expand All Advertisement PDF DownloadLoading ...