Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Advances in Therapy
Published in: Advances in Therapy 12/2016

Open Access 01-12-2016 | Review

α1-Blockers in Men with Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Obstruction: Is Silodosin Different?

Authors: Claus G. Roehrborn, Francisco Cruz, Ferdinando Fusco

Published in: Advances in Therapy | Issue 12/2016

Login to get access

Abstract

Available α1-blockers (ABs) have different profiles of receptor selectivity. Silodosin exhibits the highest selectivity for the α1A adrenergic receptor. This pharmacological feature couples with a singular urodynamic and clinical profile. The magnitude of bladder outlet obstruction improvement in patients receiving silodosin is higher if compared to other ABs. From a clinical point of view, current evidence suggests an advantage in favor of silodosin in terms of nocturia improvement and cardiovascular safety. The incidence of ejaculatory dysfunction with silodosin is higher compared to other Abs.
Literature
1.
Malaeb BS, Yu X, McBean AM, Elliott SP. National trends in surgical therapy for benign prostatic hyperplasia in the United States (2000–2008). Urology. 2012;79(5):1111–6.CrossRefPubMedPubMedCentral
2.
Gravas S, Bach T, Bachmann A, et al. Guidelines on management of non-neurogenic male lower urinary tract symptoms (LUTS), incl. benign prostatic obstruction (BPO). Arnheim: European Association of Urology; 2014.
3.
Lepor H. Pathophysiology of benign prostatic hyperplasia: insights from medical therapy for the disease. Rev Urol. 2009;11(Suppl 1):S9–13.PubMedPubMedCentral
4.
Andersson KE, Gratzke C. Pharmacology of alpha1-adrenoceptor antagonists in the lower urinary tract and central nervous system. Nat Clin Pract Urol. 2007;4:368–78.CrossRefPubMed
5.
Piascik MT, Perez DM. Alpha1-adrenergic receptors: new insights and directions. J Pharmacol Exp Ther. 2001;298(2):403–10.PubMed
6.
Kim YW, Park J, Chung H, et al. The effectiveness of silodosin for nocturnal polyuria in elderly men with benign prostatic hyperplasia: a multicenter study. Int Neurourol J. 2015;19(3):190–6.CrossRefPubMedPubMedCentral
7.
Nasu K, Moriyama N, Kawabe K, et al. Quantification and distribution of α1-adrenoceptor subtype mRNAs in human prostate: comparison of benign hypertrophied tissue and nonhypertrophied tissue. Br J Pharmacol. 1996;119:797–803.CrossRefPubMedPubMedCentral
8.
Rossi M, Roumeguère T. Silodosin in the treatment of benign prostatic hyperplasia. Drug Des Devel Ther. 2010;4:291–7.PubMedPubMedCentral
9.
Osman NI, Chapple CR, Cruz F, Desgrandchamps F, Llorente C, Montorsi F. Silodosin: a new subtype selective alpha-1 antagonist for the treatment of lower urinary tract symptoms in patients with benign prostatic hyperplasia. Expert Opin Pharmacother. 2012;13:2085–96.CrossRefPubMed
10.
Shibata K, Foglar R, Horie K, et al. KMD-3213, a novel, potent, alpha 1a-adrenoceptor-selective antagonist: characterization using recombinant human alpha 1-adrenoceptors and native tissues. Mol Pharmacol. 1995;48:250–8.PubMed
11.
Novara G, Chapple CR, Montorsi F. A pooled analysis of individual patient data from registrational trials of silodosin in the treatment of non-neurogenic male lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). BJU Int. 2014;114:427–33.PubMed
12.
Tatemichi S, Kobayashi K, Maezawa A, Kobayashi M, Yamazaki Y, Shibata N. Alpha1-adrenoceptor subtype selectivity and organ specificity of silodosin (KMD-3213). Yakugaku Zasshi. 2006;126:209–16.CrossRefPubMed
13.
Matsukawa Y, Gotoh M, Komatsu T, Funahashi Y, Sassa N, Hattori R. Efficacy of silodosin for relieving benign prostatic obstruction: prospective pressure flow study. J Urol. 2009;182:2831–5.CrossRefPubMed
14.
Yamanishi T, Mizuno T, Tatsumiya K, Watanabe M, Kamai T, Yoshida K. Urodynamic effects of silodosin, a new alpha 1A-adrenoceptor selective antagonist, for the treatment of benign prostatic hyperplasia. Neurourol Urodyn. 2010;29:558–62.PubMed
15.
Fusco F, Palmieri A, Ficarra V, et al. α1-blockers improve benign prostatic obstruction in men with lower urinary tract symptoms: a systematic review and meta-analysis of urodynamic studies. Eur Urol. 2016;69:1091–101.CrossRefPubMed
16.
Chapple CR, Montorsi F, Tammela TL, et al. Silodosin therapy for lower urinary tract symptoms in men with suspected benign prostatic hyperplasia: results of an international, randomized, double-blind, placebo- and active-controlled clinical trial performed in Europe. Eur Urol. 2011;59:342–52.CrossRefPubMed
17.
Djavan B, Marberger M. A meta-analysis on the efficacy and tolerability of alpha1-adrenoceptor antagonists in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction. Eur Urol. 1999;36(1):1–13.CrossRefPubMed
18.
Yu HJ, Lin AT, Yang SS, et al. Non-inferiority of silodosin to tamsulosin in treating patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). BJU Int. 2011;108:1843–8.CrossRefPubMed
19.
Kawabe K, Yoshida M, Homma Y, Silodosin Clinical Study Group. Silodosin, a new alpha1A-adrenoceptor-selective antagonist for treating benign prostatic hyperplasia: results of a phase III randomized, placebo-controlled, double-blind study in Japanese men. BJU Int. 2006;98:1019–24.CrossRefPubMed
20.
Capitanio U, Salonia A, Briganti A, Montorsi F. Silodosin in the management of lower urinary tract symptoms as a result of benign prostatic hyperplasia: who are the best candidates. Int J Clin Pract. 2013;67:544–51.CrossRefPubMed
21.
Marks LS, Gittelman MC, Hill LA, Volinn W, Hoel G. Rapid efficacy of the highly selective alpha1A-adrenoceptor antagonist silodosin in men with signs and symptoms of benign prostatic hyperplasia: pooled results of 2 phase 3 studies. J Urol. 2009;181(6):2634–40.CrossRefPubMed
22.
Eisenhardt A, Schneider T, Cruz F, Oelke M. Consistent and significant improvement of nighttime voiding frequency (nocturia) with silodosin in men with LUTS suggestive of BPH: pooled analysis of three randomized, placebo-controlled, double-blind phase III studies. World J Urol. 2014;32(5):1119–25.CrossRefPubMed
23.
Montorsi F, Mercadante D. Diagnosis of BPH and treatment of LUTS among GPs: a European survey. Int J Clin Pract. 2013;67(2):114–9.CrossRefPubMed
24.
Roehrborn CG, Oesterling JE, Auerbach S, et al. The Hytrin Community Assessment Trial study: a one-study of terazosin vs placebo in the treatment of men with symptomatic benign prostatic hyperplasia. HYCAT Investigator Group. Urology. 1996;47(2):159–68.CrossRefPubMed
25.
Miller M. Nocturnal polyuria in older people: pathophysiology and clinical implications. J Am Geriatr Soc. 2000;48(10):1321–9.CrossRefPubMed
26.
Kupelian V, Wei JT, O’Leary MP, Norgaard JP, Rosen RC, McKinlay JB. Nocturia and quality of life: results from the Boston area community health survey. Eur Urol. 2012;61(1):78–84.CrossRefPubMed
27.
Nickel JC, Sander S, Moon TD. A meta-analysis of the vascular-related safety profile and efficacy of α-adrenergic blockers for symptoms related tobenign prostatic hyperplasia. Int J Clin Pract. 2008;62(10):1547–59.CrossRefPubMedPubMedCentral
28.
29.
Oelke M, Gericke A, Michel MC. Cardiovascular and ocular safety of α1-adrenoceptor antagonists in the treatment of male lower urinary tract symptoms. Expert Opin Drug Saf. 2014;13(9):1187–97.CrossRefPubMed
30.
Novara G, Chapple CR, Montorsi F. Individual patient data from registrational trials of silodosin in the treatment of non-neurogenic male lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH): subgroup analyses of efficacy and safety data. BJU Int. 2015;115(5):802–14.CrossRefPubMed
31.
Montorsi F, Gandaglia G, Chapple C, Cruz F, Desgrandchamps F, Llorente C. Effectiveness and safety of silodosin in the treatment of lower urinary tract symptoms in patients with benign prostatic hyperplasia: a European phase IV clinical study (SiRE study). Int J Urol. 2016. 23(7):572–9.
32.
Novara G, Tubaro A, Sanseverino R, et al. Systematic review and meta-analysis of randomized controlled trials evaluating silodosin in the treatment of non-neurogenic male lower urinary tract symptoms suggestive of benign prostatic enlargement. World J Urol. 2013;31(4):997–1008.CrossRefPubMed
33.
Lowe FC. Role of the newer alpha, -adrenergic-receptor antagonists in the treatment of benign prostatic hyperplasia-related lower urinary tract symptoms. Clin Ther. 2004;26(11):1701–13.CrossRefPubMed
34.
35.
Gacci M, Ficarra V, Sebastianelli A, et al. Impact of medical treatments for male lower urinary tract symptoms due to benign prostatic hyperplasia on ejaculatory function: a systematic review and meta-analysis. J Sex Med. 2014;11(6):1554–66.CrossRefPubMed
36.
Kaplan SA. Side effects of alpha-blocker use: retrograde ejaculation. Rev Urol. 2009;11(Suppl 1):S14–8.PubMedPubMedCentral
37.
van Kerrebroeck P, et al. Efficacy and safety of a new prolonged release formulation of alfuzosin 10 mg once daily versus alfuzosin 2.5 mg thrice daily and placebo in patients with symptomatic benign prostatic hyperplasia. ALFORTI Study Group. Eur Urol. 2000;37(3):306–13.CrossRefPubMed
38.
Kirby RS, Andersen M, Gratzke P, Dahlstrand C, Høye K. A combined analysis of double-blind trials of the efficacy and tolerability of doxazosin-gastrointestinal therapeutic system, doxazosin standard and placebo in patients with benign prostatic hyperplasia. BJU Int. 2001;87(3):192–200.CrossRefPubMed
39.
Griwan MS, Karthikeyan YR, Kumar M, Singh BJ, Singh SK Comparative evaluation of naftopidil and tamsulosin in the treatment of patients with lower urinary tract symptoms with benign prostatic hyperplasia. Urol Ann. 2014;6(3):181–6.CrossRefPubMedPubMedCentral
Metadata
Title
α1-Blockers in Men with Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Obstruction: Is Silodosin Different?
Authors
Claus G. Roehrborn
Francisco Cruz
Ferdinando Fusco
Publication date
01-12-2016
Publisher
Springer Healthcare
Published in
Advances in Therapy / Issue 12/2016
Print ISSN: 0741-238X
Electronic ISSN: 1865-8652
DOI
https://doi.org/10.1007/s12325-016-0423-5

Other articles of this Issue 12/2016

Advances in Therapy 12/2016 Go to the issue

Original Research

Lack of a Pharmacokinetic Interaction Between SYM-1219 Granules Containing 2 Grams of Secnidazole and a Combined Oral Contraceptive in a Phase 1, Randomized, Open-Label Study in Healthy Female Volunteers

Review

Reasons for and Against Use of Non-absorbable, Synthetic Mesh During Pelvic Organ Prolapse Repair, According to the Prolapsed Compartment

Review

Chemosaturation Percutaneous Hepatic Perfusion: A Systematic Review

Review

Points to Consider in the Foundation of Multidisciplinary Units for Psoriatic Arthritis: A Delphi Study and a Systematic Review of the Literature

Letter

Important Considerations When Determining the Cost-effectiveness of Viscosupplements in the Treatment of Knee Osteoarthritis: Letter to the Editor regarding Rosen, J., Sancheti, P., Fierlinger, A. et al. Adv Ther (2016) 33: 998. doi:10.1007/s12325-016-0331-8

Original Research

Assessing Short-term Deterioration in Maintenance-naïve Patients with COPD Receiving Umeclidinium/Vilanterol and Tiotropium: A Pooled Analysis of Three Randomized Trials
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits