Tamsulosin Combination Therapy Research Articles

Effectiveness of tadalafil and tamsulosin combination in benign prostatic hyperplasia: A prospective cohort study at a tertiary care center

Background: Benign prostatic hyperplasia (BPH) is one of the major causes of lower urinary tract symptoms (LUTS) in men. The uroselective tamsulosin helps in rapid reduction of prostate symptoms and its combination with Tadalafil, a phosphodiesterase inhibitor leads to synergistic benefit improving the LUTS of BPH. Aims and Objectives: This study was conducted with the aim to assess the effectiveness of synergistic effect of Tadalafil and Tamsulosin in improving the symptoms of BPH patients. Materials and Methods: A prospective cohort study was conducted among the patients admitted with LUTS due to BPH in the surgery ward of Annapoorna Medical College. A total of 100 patients were included in the study. The control group was administered 0.4 mg of tamsulosin and the study group was administered with combination of tadalafil 5 mg and tamsulosin 0.4 mg for 3 weeks and followed up at an interval of 3 weeks, 1 month, and 6 months. Paired t-test was used to compare the international prostate symptom score (IPSS) mean scores. Results: A total of 100 patients were included in the study. There was significant improvement in the post-voided volume of the study group in comparison to the control. The IPPS score of the study group at the baseline was 16.39±4.89 which was decreased to a score of 11.42±3.39 after the combination drug therapy with P<0.001 which was statistically significant. Conclusion: The combination therapy of tamsulosin and tadalafil marked an improvement in the symptoms of BPH which can be noted with fall down of IPSS score after the therapy.

Role of tamsulosin a selective alpha 1a-1d blocker vs. combination therapy of tamsulosin and solifenacin M3 antagonist in DJ stent related morbidity: obstructive and irritative scores

Background: nowadays Urolithiasis is very common in general population. Due to the advent of newer lithotripsy techniques, endoscopic procedures are used in most of the cases and to promote stone clearance DJ stents are kept after all the endoscopic procedures. Methods: This is a prospective study conducted among indoor patients from January 2021 to May 2022 in 90 indoor patients of tertiary care hospital. Results: In our study go 90 patients, pre DJ insertion, IPSS score in group A was 10.22 and Group B was 9.64, Mean Quality of Life in Group A was 1.77 and group B was 1.37, Visual analogue scale in group A was 2.08 and group B was 2.24. On Day 1 Post DJ insertion, IPSS score in group A was 12.26 and Group B was 11.68, Mean Quality of Life in Group A was 1.44 and group B was 1.28, Visual analogue scale in group A was 2.55 and group B was 2.28. Conclusions: Use of combination of selective alpha 1a-1d blocker and M3 antagonist significantly reduces the DJ stent related morbidity after endoscopic treatment for urolithiasis.

Understanding Treatment Response in Individual Profiles of Men with Prostatic Enlargement at Risk of Progression

BackgroundIt is unclear how cumulative multivariable effects of clinically relevant covariates impact response to pharmacological treatments for lower urinary tract symptoms (LUTS)/benign prostatic enlargement (BPE). ObjectiveTo develop models to predict treatment response in terms of International Prostate Symptom Score (IPSS) and the risk of acute urinary retention (AUR) or BPE-related surgery, based on large data sets and using as predictors baseline characteristics that commonly define the risk of disease progression. Design, setting, and participantsA total of 9167 patients with LUTS/BPE at risk of progression in three placebo-controlled dutasteride trials and one comparing dutasteride, tamsulosin, and dutasteride + tamsulosin combination therapy (CT) were included in the analysis to predict response to placebo up to 24 mo and active treatment up to 48 mo. Outcome measurements and statistical analysisPredictors included age, IPSS, total prostate volume (PV), maximum urinary flow rate (Qmax), prostate-specific antigen, postvoid residual urine (PVR), α-blocker usage within 12 mo, and randomised treatment. A generalised least-squares model was developed for longitudinal IPSS and a Cox proportional-hazards model for time to first AUR/surgery. Results and limitationsThe vast majority of patients benefit from dutasteride or CT when compared with tamsulosin alone. The predicted IPSS improvement with dutasteride or CT increased with greater PV and severity of symptoms at baseline. The tamsulosin effect was lower with greater baseline PV and tended to decrease over time. Predicted AUR/surgery risk was greater with tamsulosin versus CT or dutasteride; this risk increased with larger PV, higher PVR, and lower Qmax (all at baseline). An educational interactive web-based tool facilitates visualisation of the results (www.bphtool.com). Limitations include: the placebo and active-treatment predictions are from different studies, the lack of similar studies for external validation, and the focus on a population at risk of progression from the 4-yr CombAT study. ConclusionsPredictive modelling based on large data sets and visualisation of the risk for individual profiles can improve our understanding of how risk factors for disease progression interact and affect response to different treatments, reinforcing the importance of an individualised approach for LUTS/BPE management. Patient summaryWe used data from previous studies to develop statistical models for predicting how men with lower urinary tract symptoms or benign prostate enlargement and at risk of disease complications respond to certain treatments according to their individual characteristics.

Effect of Combination of Tamsulosin and Tadalafil in Benign Prostate Hyperplasia Patients on International Prostate Symptom Score

Background: Benign prostate hyperplasia (BPH) is the most common pathological condition that contributes to lower urinary tract symptoms (LUTS) in men. Alpha1-blockers are recommended as first-line therapy for LUTS due to BPH (LUTS-BPH). Phosphodiesterase 5 (PDE5-I) inhibitors, which have been used as first-line therapy for erectile dysfunction, have also been found to be effective in treating LUTS-BPH. However, the appropriate combination therapy strategy is still unclear until now.
 Methods: This study used an experimental design on 17 BPH patients on medical therapy. The patient was given Tamsulosin 0.4 mg monotherapy for 7 days and then continued combination therapy with Tamsulosin 0.4 mg and Tadalafil 5 mg for the next 7 days. Total IPSS score, obstruction, irritation, and quality of life (QoL) were assessed before treatment, after monotherapy, and after combination therapy.
 Results: The mean age of the research subjects was 62.12 years. Improvements in the total IPSS value, obstruction, irritation, and QoL showed significant changes in both types of therapy compared to the initial value. Combination therapy gave better results than monotherapy, with a mean difference in the decrease in the total IPSS value of 4.41 (p<0.001), obstruction of 3.18 (p<0.001), irritation of 1.41 (p<0.001), and QoL 0.6 (p<0.001).
 Conclusion: The combination therapy of Tamsulosin 0.4 mg with Tadalafil 5 mg once a day showed clinically and significantly better results than monotherapy in total IPSS, obstruction, irritation, and QoL values in LUTS-BPH patients.

Penilaian Erection Hardness Score Pasien Benign Prostatic Hyperplasia yang Ditangani dengan Tamsulosin dan Kombinasi Tamsulosin-Dutasteride

The goal of Benign Prostate Hyperplasia (BPH) therapy is to relieve symptoms and maintain disease progression as well as the side effects of drugs and their benefits for improving the quality of life and sexual quality. This study aimed to assess the effect of tamsulosin therapy with combination therapy of tamsulosin and dutasteride on the erection hardness score (EHS) in men with LUTS due to BPH. This study is a cross-sectional study which assesses and compares differences in erection hardness scores (EHS) of patients with benign prostatic hyperplasia (BPH) before and after tamsulosin therapy and the combination of tamsulosin + dutasteride. After three months of therapy, the group of subjects given tamsulosin had an IPSS score of 12.87 (p=0.00), IIEF-5 15.43 (p=0.51), EHS 2.6 (p=0.08), while the tamsulosin + dutasteride group had an IPSS score 12.53(p=0.00), IIEF-5 15.83 (p=0.02), and EHS 2.6 (p=0.01). The decrease in EHS was more statistically significant in treatment with tamsulosin + dutasteride combination therapy compared with tamsulosin monotherapy, this was due to the effect of each drug combined.

Drug Prescription Patterns During Initial Treatment of Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia: A Study Based on Health Insurance Review and Assessment Database.

BackgroundTo evaluate the drug prescription patterns for men diagnosed with benign prostatic hyperplasia (BPH) in Korea.MethodsWe extracted the data of 3% of the national patient samples including men aged ≥ 40 years between 2012 and 2017 from the Health Insurance Review and Assessment database and investigated the drugs prescribed for men with the BPH code N40. Men with a diagnosis of BPH but not receiving treatment were excluded. The primary outcome was the drugs prescribed and the changes in drug prescription pattern over 6 years for men first diagnosed with BPH.ResultsAlpha blockers were the most commonly prescribed drugs in men with BPH, and tamsulosin was the most common. The proportion of prescriptions increased steadily. The number of prescriptions for anticholinergics (ACH) increased, but decreased with the start of mirabegron prescriptions in 2015. Prescriptions of mirabegron are increasing rapidly and replacing ACH. Based on the prescription pattern by drug category, alpha blocker monotherapy decreased, whereas combination therapies such as alpha blocker + 5-alpha-reductase inhibitors (5ARI), and alpha blocker + 5ARI + ACH increased steadily. As for the number of prescriptions by drug ingredient, tamsulosin monotherapy was the most common, and the combination therapy of tamsulosin and mirabegron increased.ConclusionAlpha blockers were the most commonly prescribed drug for men first diagnosed with BPH in Korea from 2012 to 2017, and tamsulosin was the most common alpha blocker. Prescriptions of combination therapy and mirabegron are gradually increasing.

Comparative Efficacy of Tamsulosin Versus Tamsulosin Plus Finasteride in Patients with Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hypertrophy, a Randomized Open Label Parallel Group Study

Background: Benign prostatic hypertrophy (BPH) is a common entity among elderly men and is responsible for significant disability. Medical treatment for BPH has played a major role in improving the symptoms associated with bladder outlet obstruction. Recent guidelines recommend the combination of an alpha-1 blocker and a 5-ARI as first-line treatment of men with moderate-to-severe LUTS. There is limited study data to support which is the effective therapy for BPH/LUTS in a tertiary care hospital in India. Methods: A randomized, open labelled, double blind, active control parallel group study comparing the safety and efficacy of tamsulosin versus tamsulosin+finasteride in subjects with lower urinary tract symptoms secondary to benign prostatic hypertrophy. The subjects were randomized after obtaining written informed consent. The subjects were recruited from the patient population that was attending the Out-Patient department of Urology, Sri Ramachandra Medical College & Research Institute, Sri Ramachandra University. Results: A total sample of 60 subjects, 30 into each group was enrolled. In the tamsulosin group, according to IPSS score, 11 patients who had moderate symptoms (36.7%) became mild, and among 19 patients who had severe symptoms (63.3%), 12 patients became mild (40%) and 7 patients became moderate (23.3%) with a p value of 0.021 which is statistically significant. In the tamsulosin+ finasteride group, according to IPSS score, 10 patients who had moderate symptoms (33.3%) became mild, and among 20 patients who had severe symptoms (66.7%), 12 patients became mild (40%) and 8 patients became moderate (26.7%) with a p value of 0.020 which is statistically significant. When comparing between the two groups, 76.7% attained mild symptoms in group 1 and 73.3% patients attained mild symptoms in group 2 with a p value of 0.766 which is statistically not significant. Conclusion: To conclude tamsulosin 0.4mg is as effective as the combination therapy of tamsulosin 0.4mg and finasteride 5mg in the treatment of lower urinary tract symptoms secondary to Benign prostatic hypertrophy.

Efficacy of Phloroglucinol Tamsulosin Combination Therapy for Medical Expulsion of Lower Ureteral Calculi and Influence on Patients’ Cys-C Level

Objective: Phloroglucinol is a myotropic, non-atropine and non-papaverine smooth muscle antispasmodic which directly acts on the smooth muscles of the gastrointestinal tract and the urogenital tract with no anticholinergic effect, no symptoms like xerostomia, visual impairment, dysuria, hypotension, increased heart rate, and arrhythmia etc. To investigate the efficacy of phloroglucinol tamsulosin combination therapy for medical expulsion of lower ureteral calculi and influence on patients’ Cys-C level. Methods: Equally randomized 136 patients with lower ureteral calculi in our hospital into mono therapy group (phloroglucinol alone) and combination therapy group (additional tamsulosin was advised). The expulsion rate, expulsion time, stone diameter and levels of IL-10, CRP, NGAL, Cys-C, KIM-1 were compared between two groups, also with the effectiveness and the rate of adverse reactions. Results: The combination therapy group showed higher expulsion rate (P<0.05) and shorter expulsion time (P<0.05) than that of the mono therapy group and the stone diameter was slightly larger as well (P<0.05). Also, patients under combination treatment had elevated IL-10, CRP, NGAL, Cys-C and KIM-1 levels and a better overall response rate (P<0.05) while it was associated with a slightly higher rate of adverse reactions (P>0.05). Conclusions: Phloroglucinol tamsulosin combination therapy had clear advantages on medical expulsion of lower ureteral calculi in respect of higher expulsion rate and elevated IL-10, CRP, NGAL, Cys-C and KIM-1 levels with larger stone diameter in a shorter time.

A Prospective Study on Evaluation of Efficacy of Combination Therapy of Tamsulosin and Deflazacort In Ureteric Stone Expulsion

The patients with ureteric stone are increasing day by day all over the world. A ureteric stone is a mineral mass in the ureter which may or may not originated in the kidney and travelled down to the ureter. The presence of stone in ureter causes inflammation and edema. There are mainly four types of ureteric stone such as Calcium stones, Uric acid stones, Struvite stone, Cystine stone. About 23-53% of spontaneous stone expulsion occurs where the size of stone is 5-10mm diameter. Tamsulosin is an alpha 1 adrenergic blocker which has a spasmolytic action and thus hasten stone expulsion. Deflazacort is a corticosteroid prodrug which acts on the glucocorticoid receptor to show an anti-inflammatory effect. Deflazacort decreases the edema and when prescribed along with alpha 1 adrenergic receptor blocker it facilitate the expulsion of calculi. This study was conducted in 20 patients diagnosed with ureteric calculi. The study was conducted by using suitable proforma for collecting various data’s like site of stones, presence of hydronephrosis, signs and symptoms. Health related quality of life of the patients with ureteric calculi under the treatment of Tamsulosin and Deflazacort combination were assessed by using Wisconsin Stone-QOL questionnaire. As counselling aid patients information leaflet was provided. The patients were asked to review after 10 days of taking the medication. At the end of the study all the parameters and scores were compared with baseline to the end of the study. In our study we analyzed that the data collected from 20 patients diagnosed with ureteric calculi accessed the improvement of quality of life of patients under the treatment of Tamsulosin and Deflazacort combination by using Wisconsin Stone-QOL questionnaire. The observed difference before and after the treatment with Tamsulosin and Deflazacort w

EFFECT OF TADALAFIL ADD-ON THERAPY IN PATIENTS WITH LOWER URINARY TRACT SYMPTOMS DUE TO BENIGN PROSTATIC HYPERPLASIA REFRACTORY TO TAMSULOSIN MONOTHERAPY: RANDOMIZED, CONTROLLED TRIAL

Background: Benign prostatic hyperplasia (BPH) is a non-malignant hyperplasia of prostatic cells.Most of patients with BPH present with lower urinary tract symptoms (LUTS). LUTS and BPH are highly prevalent entities in aging men. Objectives: To assess the efficacy and safety of fixed-dose combination therapy of Tamsulosin 0.4 mg plus Tadalafil 5mg versus Tamsulosin 0.4mg, plus placebo once daily in the treatment of patients with LUTS related to BPH whose were refractory to tamsulosin monotherapy. Patients and Methods: In this randomized controlled clinical study, carried out at Al-Azhar University Hospitals, 80 patients complaining of LUTS related to BPH were randomly divided into two equal groups. Fortypatients received fixed-dose combinations therapy of Tamsulosin 0.4mg/day and tadalafil 5mg /day for 6 months (group A), and forty patients received Tamsulosin 0.4mg plus placebo/day for 6 months (group B). The International Prostate Symptom Score (IPSS), Qmax, Post void residual urine (PVRU) and International Index of Erectile Function (IIEF-5) score used at baseline before starting treatment, at 3 months and 6 months to assess the efficacy in both groups. Results: With combination therapy group, there was significant improvement in IPSS score P value (<0.001), significant increase in Qmax P value (<0.001), and significant decrease in PVRU P value (<0.001) compared with placepo group. IIEF- 5 score changes showed no statistically significant difference between bothgroups (P value) (0.102) in tadalafil group. Conclusion: The fixed-dose combination of Tamsulosin 0.4 mg/day and Tadalafil 5 mg/day are significantly superior to Tamsulosin 0.4 mg/day plus placebo for the treatment of LUTS related to BPH whose were refractory to tamsulosin, supporting favorable benefit-risk balance of the fixed-dose combinations therapy for the treatment of LUTS related to BPH because of its synergistic effects, well toleration and safety.

Efficacy of Phloroglucinol Tamsulosin Combination Therapy for Medical Expulsion of Lower Ureteral Calculi and Influence on Patients’ Cys-C Level

Objective: Phloroglucinol is a myotropic, non-atropine and non-papaverine smooth muscle antispasmodic which directly acts on the smooth muscles of the gastrointestinal tract and the urogenital tract with no anticholinergic effect, no symptoms like xerostomia, visual impairment, dysuria, hypotension, increased heart rate, and arrhythmia etc. To investigate the efficacy of phloroglucinol tamsulosin combination therapy for medical expulsion of lower ureteral calculi and influence on patients’ Cys-C level. Methods: Equally randomized 136 patients with lower ureteral calculi in our hospital into mono therapy group (phloroglucinol alone) and combination therapy group (additional tamsulosin was advised). The expulsion rate, expulsion time, stone diameter and levels of IL-10, CRP, NGAL, Cys-C, KIM-1 were compared between two groups, also with the effectiveness and the rate of adverse reactions. Results: The combination therapy group showed higher expulsion rate (P 0.05). Conclusions: Phloroglucinol tamsulosin combination therapy had clear advantages on medical expulsion of lower ureteral calculi in respect of higher expulsion rate and elevated IL-10, CRP, NGAL, Cys-C and KIM-1 levels with larger stone diameter in a shorter time.

Comparative Efficacy and Safety of a Fixed-Dose Combination Therapy of Tamsulosin and Tadalafil versus Tadalafil alone for BPH Patients with Lower Urinary Tract Symptoms and Erectile Dysfunction

Abstract Background benign prostatic hyperplasia (BPH) is a disorder histologically characterized as the nonmalignant hyperplasia of prostatic cells. Most of patients with benign prostate hyperplasia present with lower urinary tract symptoms (LUTS). Aim of the Study to assess the efficacy and safety of fixed-dose combinations therapy of Tamsulosin &amp; Tadalafil versus Tadalafil alone in treatment for BPH patient with lower urinary tract symptoms (LUTS) and erectile dysfunction (ED). Patients and Methods this is a randomized controlled clinical study at Urology Department, Faculty of Medicine, Ain Shams University (El Demerdash Hospital) &amp; Damanhour National Institute Hospital from 1-1-2018 till 1-9-2018. It concluded men of 45 years old or older with a history of LUTS secondary to BPH of at least 6 months were eligible for this study. Patients agreed not to use BPH medications during the research other than the study medications. Results the study showed that the fixed-dose combinations of Tamsulosin and Tadalafil significantly improve IPSS score and Qmax more than with Tadalafil 5 mg/day alone. Furthermore, PVRU significantly decreased with the fixed-dose combinations of Tamsulosin and Tadalafil more than with Tadalafil alone. Fixed-dose combinations of Tamsulosin 0.4 mg plus Tadalafil 5 mg were determined to be safe, efficacious, and well tolerated in the subjects investigated, which suggests the new fixed-dose combinations therapy can offer clinically relevant benefits for patients with LUTS complaints and desiring amelioration for comorbid ED complaints. Conclusion the study shows that the fixed- dose combination of Tamsulosin 0.4 mg/day and Tadalafil 5 mg/day are significantly superior to Tadalafil 5 mg/day alone for the treatment of BPH patients with LUTS and non-inferiority in treatment of ED Without showing any clinically significant safety issues, supporting favorable benefit-risk balance of the fixed-dose combinations of therapy for the treatment of BPH patients with LUTS and ED because of its synergistic effects, well toleration and its safety.

THE EFFECTIVENESS OF TAMSULOSIN, SOLIFENACIN, AND COMBINATIONS THERAPY TAMSULOSIN ADDED SOLIFENACIN ON LOWER URINARY TRACT SYMPTOMS AFTER DOUBLE J STENT INSERTION

Objective: Insertion of DJ Stent is a procedure that is often done by urologist. Insertion of DJ Stent can cause LUTS complaints and greatly affect the physical and psychosocial health of patients. The aim of this study was to determine the effectiveness difference of tamsulosin therapy 0.4 mg/day, solifenacin 5 mg/day and the combination of tamsulosin therapy 0.4 mg/day added solifenacin 5 mg/day to manage LUTS complaint after DJ Stent insertion. Material &amp; Methods: This study was a randomized placebo-controlled trial. There were 4 groups, group I received placebo, group II received tamsulosin 0.4 mg/day, group III received solifenacin 5 mg/day, and group IV received combination therapy of tamsulosin 0.4 mg/day added solifenacin 5 mg/day. Evaluation based on International Prostatic Symptom Score (IPSS) and Ureteral Stent Symptom Questioner (USSQ) score. Data were analyzed using SPSS 21.0. It is said to be significant if p&lt;0.05. Results: There were a total of 32 samples consist of 19 (59.3%) men and 13 (40.6%) women. There were significant improvements in the score of total IPSS, IPSS storage and IPSS quality of life score in patients who received combination therapy (p&lt;0.05) when compared with patients who received monotherapy. The highest decrease in USSQ scores 1, 2, 3, 4, 5 and 6 were in the group that received combination therapy when compared with the monotherapy group. Conclusion: The combination therapy is safe and effective to improve IPSS total, IPSS storage and IPSS Quality of Life scores compared with monotherapy.

Economic Evaluation of Combination Therapy Versus Monotherapy for Treatment of Benign Prostatic Hyperplasia in Hong Kong.

Background: Lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) is a common condition affecting men. Studies have shown that the prevalence of LUTS/BPH increases with age, which will cause considerable economic burden to the healthcare system and society. The aim of the present study was to evaluate the long term cost effectiveness of dutasteride and tamsulosin therapy compared to tamsulosin alone in men with BPH in Hong Kong.Methods: A Markov decision model was constructed to estimate the economic impact from a healthcare payers’ perspective, which only included direct costs. Analyses were conducted for a 4-year time frame.Results: When compared to tamsulosin alone, combination therapy was more expensive but also more effective in preventing complications and reduced the need for surgery. Over life-time projection suggest that combination therapy will be cost-effective if the willingness-to pay threshold of USD 20,000.Conclusion: Findings of this study found that combination therapy of tamsulosin and dutasteride was more cost-effective compared to tamsulosin alone across a wide range of scenario.

Efficacy and Safety of a Fixed-Dose Combination Therapy of Tamsulosin and Tadalafil for Patients With Lower Urinary Tract Symptoms and Erectile Dysfunction: Results of a Randomized, Double-Blinded, Active-Controlled Trial

BackgroundPhosphodiesterase type 5 inhibitors and α-adrenergic blocking agents (α-blockers) are widely used for the treatment of erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). AimsTo assess the efficacy and safety of fixed-dose combinations (FDCs) of tamsulosin and tadalafil compared with tadalafil monotherapy in patients with comorbid BPH-associated LUTS and ED. MethodsA randomized, double-blinded, active-controlled trial was conducted of 510 men with BPH-associated LUTS and ED. Patients were treated with FDCs of tamsulosin 0.4 mg plus tadalafil 5 mg (FDC 0.4/5 mg), tamsulosin 0.2 mg plus tadalafil 5 mg (FDC 0.2/5 mg), or tadalafil 5 mg for a 12-week treatment period. For a subsequent 12-week extension period, the patients were administered FDC 0.4/5 mg. OutcomesThe primary outcomes were changes from baseline in total International Prostate Symptom Score (IPSS) and International Index of Erectile Function erectile function domain (IIEF-EF) score at week 12 to prove superiority and non-inferiority of FDCs compared with tadalafil 5 mg. The safety assessments were adverse reactions, laboratory test results, and vital signs at week 24. ResultsThe mean changes in total IPSS and IIEF-EF scores were −9.46 and 9.17 for FDC 0.4/5 mg and −8.14 and 9.49 for tadalafil 5 mg, respectively, which indicated superiority in LUTS improvement (P = .0320) and non-inferiority in ED treatment with FDC 0.4/5 mg compared with tadalafil 5 mg. However, the results from FDC 0.2/5 mg failed to demonstrate superiority in LUTS improvement. No clinically significant adverse events regarding the investigational products were observed during the 24-week period. Clinical ImplicationsThe FDC 0.4/5 mg is the first combined formulation of an α-blocker and a phosphodiesterase type 5 inhibitor that offers benefits in patient compliance and as add-on therapy in patients with comorbid BPH-associated LUTS and ED. Strengths and LimitationsThe study clearly demonstrated the advantage of FDC 0.4/5 mg. The main advantage of FDC 0.4/5 mg was the enhanced efficacy on BPH-associated LUTS comorbidity with ED, the lower incidence of side effects, and the simplification and convenience of therapy, which led to better overall patient compliance. However, the lack of a tamsulosin monotherapy control group was a limitation of this study. ConclusionThe FDC 0.4/5 mg therapy was safe, well tolerated, and efficacious, indicating that combination therapy could provide clinical benefits for patients with BPH-associated LUTS complaints and ameliorate the comorbidity of ED.Kim SW, Park NC, Lee SW, et al. Efficacy and Safety of a Fixed-Dose Combination Therapy of Tamsulosin and Tadalafil for Patients With Lower Urinary Tract Symptoms and Erectile Dysfunction: Results of a Randomized, Double-Blinded, Active-Controlled Trial. J Sex Med 2017;14:1018–1027.

Clinical efficacy of combination therapy of Tamsulosin plus Tolterodine sustained-release capsules on benign prostatic hyperplasia with overactive bladder in elderly men

Objective To evaluate the efficacy of combination therapy of cholinergic receptor blocker Tolterodine and Alpha-adrenergic receptor blocker Tamsulosin sustained-release capsules on benign prostatic hyperplasia(BPH)with overactive bladder(OAB)in elderly men. Methods A total of 97 male BPH patients aged 80 years and over(80~98 years old, mean 87.7 years old)were enrolled in this study, who met the diagnosis and treatment guidelines of OAB formulated by Chinese Urological Association and were admitted to our hospital from Jan. 2015 to July. 2015. Patients were randomly divided into Tamsulosin group(n=51, treated with Tamsulosin)and combination group(n=46, treated with Tamsulosin and Tolterodine). Results In Tamsulosin group after treatment, the international prostate symptom score(IPSS)was reduced from(18.3±2.7)to(13.3±3.1)(t=14.94, P 0.05). The total incidences of adverse events(mainly mouth dryness)had no significant differences between the Tamsulosin group and the combination group(8.7% vs. 5.9%, χ2=99.47, P>0.05). No acute urinary retention was found in the two groups. Conclusions The combination therapy of Tamsulosin and Tolterodine has better efficacy and safety than single Tamsulosin application in the treatment of BPH with OAB in elderly men. Key words: Prostatic hyperplasia; Urinary bladder, overactive; Muscarinic antagonists; Adrenergic alpha- antagonists

Solifenacin and Tamsulosin Combination Therapy Decreases Urine Nerve Growth Factor/Creatinine Levels in Men

To evaluate urinary nerve growth factor (NGF)/creatinine (Cr) levels from men with symptomatic lower urinary tract symptoms (LUTS) and measure the effect of combination therapy with solifenacin and tamsulosin. From January 2012 to February 2014, all male patients referred for evaluation and management of LUTS were screened for enrollment. In all subjects, urinary NGF and Cr levels were measured and normalized to the urinary Cr concentrations (NGF/Cr). Uroflow, postvoid residual, and symptom questionnaires were measured at baseline, 4 weeks, 8 weeks, and 12 weeks after starting combination therapy with solifenacin 5 mg and tamsulosin 0.4 mg. The primary endpoint was urinary NGF and NGF/Cr change from baseline compared with week 12. Ten patients were recruited into the study. Peak urine flow at baseline 20.3 ± 2.5 ml/s and postvoid residual 45.3 ± 13.6 ml did not significantly change with 3 months of combination treatment 14.9 ± 1.8 ml/s and 58.5 ± 23.9 ml. However, urine NGF/Cr (pg/mg) levels were significantly reduced following treatment with levels of 39.7 ± 6.6 at baseline to 17.9 ± 5.1 at 3 months (P value <.05). The decrease in urine NGF/Cr levels correlated with significant decreases in patient reported outcomes. Male patients with LUTS had decreased urinary NGF/Cr levels after treatment with combination solifenacin and tamsulosin in this novel pilot study. This corresponded with improvement in patient reported outcomes.

Implication of ultrasound bladder parameters on treatment response in patients with benign prostatic hyperplasia under medical management

ObjectiveThe prevalence of benign prostatic hyperplasia (BPH) rapidly increases after the 4th decade of life. The combination of tamsulosin and dutasteride is a well established therapy for BPH of ≥40 g. Non-invasive urodynamic parameters can predict the outcome of medical therapy in patients with BPH. We aimed to correlate these parameters with treatment responses in BPH patients under medical management. MethodsA prospective study was conducted in the Department of Urology in our hospital from May 2014 to April 2015. A total of 100 patients with BPH ≥40 g who fulfilled our inclusion criteria were included. Treatment responses were determined by the International Prostate Symptom Score (IPSS) and uroflowmetry. Transabdominal ultrasonography with Doppler was performed to measure prostate volume, intravesical prostatic protrusion (IPP), detrusor wall thickness (DWT), the prostatic capsular artery resistive index (RI) and prostatic urethral angle (PUA) before and 3 months after combination therapy of tamsulosin and dutasteride. Treatment responses were correlated with non-invasive urodynamic parameters. ResultsThe IPSS, uroflow, age, prostate volume, RI, IPP, DWT and PUA were correlated before and after treatment. Of the 100 patients, 70 (70%) showed significant improvement and 30 (30%) showed no improvement with therapy. ConclusionUltrasound bladder parameters are useful tools for measuring the treatment response in BPH patients. Our study shows that RI and DWT significantly correlate with the treatment response in BPH patients. More importantly, pretreatment values of increased IPP and PUA determines the non-improvement of symptoms in BPH patients. Our study suggests the importance of transabdominal ultrasonography (KUB–P) with Doppler for evaluating treatment responses to medical management.

Nocturia improvement in the combination of Avodart(®) and tamsulosin (CombAT) study.

The purpose of the study was to assess the impact of dutasteride plus tamsulosin combination therapy, compared with dutasteride or tamsulosin monotherapy, on nocturia in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) using data from the 4-year CombAT study. Nocturia was assessed using Question 7 of the International Prostate Symptom Score questionnaire. Efficacy measures included as follows: mean change in nocturia at 3-month intervals up to 48 months; proportion of patients with improvement/worsening in nocturia; nocturnal voiding frequency at baseline and study end, overall and by baseline subgroups; and nocturnal voiding frequency <2 at study end in patients with a baseline score ≥ 2. In total, 4,722 patients with a mean age of 66 years were included. Mean nocturia improvements were significantly superior (p ≤ 0.01) with combination therapy than with either monotherapy (adjusted mean change from baseline in IPSS Question 7 score at month 48: combination therapy -0.5, dutasteride -0.4, tamsulosin -0.3). Reduction in nocturia score with combination therapy was significantly (p ≤ 0.01) better than tamsulosin monotherapy across all baseline subgroups tested, except for men with previous 5ARI use. Among those with a baseline IPSS Q7 score ≥ 2, more patients with combination therapy had a score <2 at month 48 (34 %) compared with dutasteride (30 %, p = 0.018) or tamsulosin (26 %, p < 0.0001). Combination therapy provided greater improvements and less worsening of nocturia compared with both dutasteride and tamsulosin monotherapies. These analyses are the first to show greater improvement with a 5ARI/α-blocker combination versus either agent alone for the management of nocturia in patients with LUTS/BPH.

MP75-03 A PROSPECTIVE RANDOMIZED OPEN-LABEL CLINICAL OBSERVATIONAL STUDY TO ASSESS THE EFFECTIVENESS OF ADDING TAMSULOSIN IN WOMEN TREATED WITH SOLIFENACIN FOR OVERACTIVE BLADDER

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Female Urology II1 Apr 2014MP75-03 A PROSPECTIVE RANDOMIZED OPEN-LABEL CLINICAL OBSERVATIONAL STUDY TO ASSESS THE EFFECTIVENESS OF ADDING TAMSULOSIN IN WOMEN TREATED WITH SOLIFENACIN FOR OVERACTIVE BLADDER Changhee Yoo, Sun Il Kim, Jae Hyun Bae, Jung Hwan Son, Cheol Young Oh, Dong Hee Yoon, Seoung Yul Lee, Seoung-Ju Lee, Sung Jin Chung, Young Kwon Hong, Jong Bo Choi, and Woo Jin Bang Changhee YooChanghee Yoo More articles by this author , Sun Il KimSun Il Kim More articles by this author , Jae Hyun BaeJae Hyun Bae More articles by this author , Jung Hwan SonJung Hwan Son More articles by this author , Cheol Young OhCheol Young Oh More articles by this author , Dong Hee YoonDong Hee Yoon More articles by this author , Seoung Yul LeeSeoung Yul Lee More articles by this author , Seoung-Ju LeeSeoung-Ju Lee More articles by this author , Sung Jin ChungSung Jin Chung More articles by this author , Young Kwon HongYoung Kwon Hong More articles by this author , Jong Bo ChoiJong Bo Choi More articles by this author , and Woo Jin BangWoo Jin Bang More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2376AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To verify additional effect of alpha-blocker to anticholinergics in women with overactive bladder (OAB). METHODS 144 women (age¡Ã18 years) were enrolled. They complained OAB symptoms with International Prostate Symptom Score ¡Ã 8 and OAB short symptom score (OABSS) ¡Ã 2 in Q3 with over 3 of total OABSS and frequency more than 8 a day on voiding diary. Any subjects with neurogenic bladder, previous pelvic operation history and urinary tract infection were excluded. They were randomly assigned to solifenacin monotherapy (Mono) group (n=71) or solifenacin and tamsulosin combination therapy (Comb) group (n=73). The primary end points were change of frequency and urgency episode in voiding diary at 4 and 12 weeks after treatment. RESULTS In the Mono group, 65 and 56 women completed the protocol at 4 and 12 weeks respectively. And, in the Comb group, 56 and 49 women completed the protocal at 4 and 12 weeks respectively. At 4 weeks, the change of mean frequency, and the change of mean urgency episode were significantly larger in the Comb group.(p=0.027, and p=0.048 respectively). However, at 12 weeks, only the change of mean urgency episode was significantly larger in the Comb group (p=0.046). (Table 1) CONCLUSIONS Tamsulosin and solifenacin combination treatment improved OAB symptoms more rapidly than solifenacin monotherapy. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e874 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Changhee Yoo More articles by this author Sun Il Kim More articles by this author Jae Hyun Bae More articles by this author Jung Hwan Son More articles by this author Cheol Young Oh More articles by this author Dong Hee Yoon More articles by this author Seoung Yul Lee More articles by this author Seoung-Ju Lee More articles by this author Sung Jin Chung More articles by this author Young Kwon Hong More articles by this author Jong Bo Choi More articles by this author Woo Jin Bang More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...