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Published in: World Journal of Urology 5/2014

01-10-2014 | Topic Paper

Fixed-dose combination PRO 160/120 of sabal and urtica extracts improves nocturia in men with LUTS suggestive of BPH: re-evaluation of four controlled clinical studies

Authors: Matthias Oelke, Richard Berges, Sandra Schläfke, Martin Burkart

Published in: World Journal of Urology | Issue 5/2014

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Abstract

Purpose

To determine the effects of the herbal fixed-dose combination PRO 160/120 (extracts from saw palmetto fruits and stinging nettle roots) on nocturnal voiding frequency, as measured by question 7 of the IPSS questionnaire, in patients with moderate-to-severe LUTS/BPH after 24 weeks of treatment compared to placebo, to the α-blocker tamsulosin, or to the 5α-reductase inhibitor finasteride.

Methods

The study is about post hoc evaluation of four published randomized, double-blind clinical trials on PRO 160/120, two compared with placebo, one with finasteride and one with tamsulosin. In addition, a pooled data analysis of the two placebo-controlled trials was conducted.

Results

We analyzed data from a total of 922 patients with a mean age of 66 years and a mean baseline nocturnal voiding frequency of 2.1. In the pooled analysis of placebo-controlled trials, nocturnal voids improved by 0.8 (29 %) with PRO 160/120 compared to 0.6 (18 %) with placebo (p = 0.015, Wilcoxon test, one-tailed). The 69 % responder rate to PRO 160/120 was significantly superior to the placebo response (52 %; p = 0.003, χ 2-test, two-tailed). The majority of responders improved by 1 void/night. Absolute improvements and response rates were consistently higher with PRO 160/120 than with placebo over a range of baseline nocturnal voiding frequencies. There were no differences between PRO 160/120 and finasteride or tamsulosin regarding absolute improvement of nocturnal voids or responds rates.

Conclusion

PRO 160/120 significantly improved nocturnal voiding frequency compared to placebo and similar to tamsulosin or finasteride.
Literature
1.
go back to reference Cornu JN, Cussenot O, Haab F, Lukacs B (2010) A widespread population study of actual medical management of lower urinary tract symptoms related to benign prostatic hyperplasia across Europe and beyond official clinical guidelines. Eur Urol 58:450–456PubMedCrossRef Cornu JN, Cussenot O, Haab F, Lukacs B (2010) A widespread population study of actual medical management of lower urinary tract symptoms related to benign prostatic hyperplasia across Europe and beyond official clinical guidelines. Eur Urol 58:450–456PubMedCrossRef
2.
go back to reference Azimi H, Khakshur AA, Aghdasi I, Fallah-Tafti M, Abdollahi M (2012) A review of animal and human studies for management of benign prostatic hyperplasia with natural products: perspective of new pharmacological agents. Inflamm Allergy Drug Targets 11:207–221PubMedCrossRef Azimi H, Khakshur AA, Aghdasi I, Fallah-Tafti M, Abdollahi M (2012) A review of animal and human studies for management of benign prostatic hyperplasia with natural products: perspective of new pharmacological agents. Inflamm Allergy Drug Targets 11:207–221PubMedCrossRef
4.
go back to reference Dreikorn K, Berges R, Höfner K, Madersbacher S, Michel MC, Muschter R, Oelke M, Reich O, Rulf W, Tschuschke C, Tunn U (2009) Therapy of benign prostate syndrome (BPS): guidelines of the German Urologists (DGU). Urologe A 48:1503–1516PubMedCrossRef Dreikorn K, Berges R, Höfner K, Madersbacher S, Michel MC, Muschter R, Oelke M, Reich O, Rulf W, Tschuschke C, Tunn U (2009) Therapy of benign prostate syndrome (BPS): guidelines of the German Urologists (DGU). Urologe A 48:1503–1516PubMedCrossRef
5.
go back to reference Oelke M, Bachmann A, Descazeaud A, Emberton M, Gravas S, Michel MC, N’Dow J, Nordling J, de la Rosette JJ (2013) EAU guidelines on the treatment and follow-up on non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol 64:118–140PubMedCrossRef Oelke M, Bachmann A, Descazeaud A, Emberton M, Gravas S, Michel MC, N’Dow J, Nordling J, de la Rosette JJ (2013) EAU guidelines on the treatment and follow-up on non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol 64:118–140PubMedCrossRef
6.
go back to reference Metzker H, Kieser M, Hölscher U (1996) Wirksamkeit eines Sabal-Urtica-Kombinationspräparats bei der Behandlung der benignen Prostatahyperplasie (BPH). Eine doppelblinde placebokontrollierte Langzeitstudie. Urologe (B) 36:292–300CrossRef Metzker H, Kieser M, Hölscher U (1996) Wirksamkeit eines Sabal-Urtica-Kombinationspräparats bei der Behandlung der benignen Prostatahyperplasie (BPH). Eine doppelblinde placebokontrollierte Langzeitstudie. Urologe (B) 36:292–300CrossRef
7.
go back to reference Lopatkin N, Sivkov A, Walther C, Schläfke S, Medvedev A, Avdeichuk J, Golubev G, Melnik K, Elenberger N, Engelmann U (2005) Long-term efficacy and safety of a combination of sabal and urtica extract for lower urinary tract symptoms—a placebo-controlled, double-blind, multicenter trial. World J Urol 23:139–146PubMedCrossRef Lopatkin N, Sivkov A, Walther C, Schläfke S, Medvedev A, Avdeichuk J, Golubev G, Melnik K, Elenberger N, Engelmann U (2005) Long-term efficacy and safety of a combination of sabal and urtica extract for lower urinary tract symptoms—a placebo-controlled, double-blind, multicenter trial. World J Urol 23:139–146PubMedCrossRef
8.
go back to reference Sökeland J, Albrecht J (1997) Combination of Sabal and Urtica extract vs. finasteride in benign prostatic hyperplasia (Alken stages I to II). Comparison of therapeutic effectiveness in a one year double-blind study. Urologe A 36:327–333PubMedCrossRef Sökeland J, Albrecht J (1997) Combination of Sabal and Urtica extract vs. finasteride in benign prostatic hyperplasia (Alken stages I to II). Comparison of therapeutic effectiveness in a one year double-blind study. Urologe A 36:327–333PubMedCrossRef
9.
go back to reference Engelmann U, Walther C, Bondarenko B, Funk P, Schläfke S (2006) Efficacy and safety of a combination of sabal and urtica extract in lower urinary tract symptoms. A randomized, double-blind study versus tamsulosin. Arzneimittelforschung 56:222–229PubMed Engelmann U, Walther C, Bondarenko B, Funk P, Schläfke S (2006) Efficacy and safety of a combination of sabal and urtica extract in lower urinary tract symptoms. A randomized, double-blind study versus tamsulosin. Arzneimittelforschung 56:222–229PubMed
10.
go back to reference van Dijk MM, Wijkstra H, Debruyne FM et al (2010) The role of nocturia in the quality of life of men with lower urinary tract symptoms. BJU Int 105:1141–1146PubMedCrossRef van Dijk MM, Wijkstra H, Debruyne FM et al (2010) The role of nocturia in the quality of life of men with lower urinary tract symptoms. BJU Int 105:1141–1146PubMedCrossRef
11.
go back to reference Scaglione F, Lucini V, Pannacci M, Caronno A, Leone C (2008) Comparison of the potency of different brands of Serenoa repens extract on 5alpha-reductase types I and II in prostatic co-cultured epithelial and fibroblast cells. Pharmacology 82:270–275PubMedCrossRef Scaglione F, Lucini V, Pannacci M, Caronno A, Leone C (2008) Comparison of the potency of different brands of Serenoa repens extract on 5alpha-reductase types I and II in prostatic co-cultured epithelial and fibroblast cells. Pharmacology 82:270–275PubMedCrossRef
12.
go back to reference Tikkinen KA, Tammela TL, Huhtala H, Auvinen A (2006) Is nocturia equally common among men and women? A population based study in Finland. J Urol 175:596–600PubMedCrossRef Tikkinen KA, Tammela TL, Huhtala H, Auvinen A (2006) Is nocturia equally common among men and women? A population based study in Finland. J Urol 175:596–600PubMedCrossRef
13.
go back to reference Marschall-Kehrel D (2004) Update on nocturia: the best of rest is sleep. Urology 64(6 Suppl 1):21–24PubMedCrossRef Marschall-Kehrel D (2004) Update on nocturia: the best of rest is sleep. Urology 64(6 Suppl 1):21–24PubMedCrossRef
14.
go back to reference Nakagawa H, Niu K, Hozawa A, Ikeda Y, Kaiho Y, Ohmori-Matsuda K et al (2010) Impact of nocturia on bone fracture and mortality in older individuals: a Japanese longitudinal cohort study. J Urol 184:1413–1418PubMedCrossRef Nakagawa H, Niu K, Hozawa A, Ikeda Y, Kaiho Y, Ohmori-Matsuda K et al (2010) Impact of nocturia on bone fracture and mortality in older individuals: a Japanese longitudinal cohort study. J Urol 184:1413–1418PubMedCrossRef
15.
go back to reference Klotz T, Brüggenjürgen B, Burkart M, Resch A (2007) The economic costs of overactive bladder in Germany. Eur Urol 51:1654–1662PubMedCrossRef Klotz T, Brüggenjürgen B, Burkart M, Resch A (2007) The economic costs of overactive bladder in Germany. Eur Urol 51:1654–1662PubMedCrossRef
16.
go back to reference Tikkininen KA, Johnson TM 2nd, Tammela TL et al (2010) Nocturia frequency, bother, and quality of life: how often is too often? A population-based study in Finland. Eur Urol 57:488–496CrossRef Tikkininen KA, Johnson TM 2nd, Tammela TL et al (2010) Nocturia frequency, bother, and quality of life: how often is too often? A population-based study in Finland. Eur Urol 57:488–496CrossRef
17.
go back to reference Mitropoulos D, Anastasiou I, Giannopoulou C et al (2002) Symptomatic benign prostatic hyperplasia: impact on partners’ quality of life. Eur Urol 41:240–244PubMedCrossRef Mitropoulos D, Anastasiou I, Giannopoulou C et al (2002) Symptomatic benign prostatic hyperplasia: impact on partners’ quality of life. Eur Urol 41:240–244PubMedCrossRef
18.
go back to reference Roehrborn CG, Van Kerrebroeck P, Nordling J (2003) Safety and efficacy of alfuzosin 10 mg once-daily in the treatment of lower urinary tract symptoms and clinical benign prostatic hyperplasia: a pooled analysis of three double-blind, placebo-controlled studies. BJU Int 92:257–261PubMedCrossRef Roehrborn CG, Van Kerrebroeck P, Nordling J (2003) Safety and efficacy of alfuzosin 10 mg once-daily in the treatment of lower urinary tract symptoms and clinical benign prostatic hyperplasia: a pooled analysis of three double-blind, placebo-controlled studies. BJU Int 92:257–261PubMedCrossRef
19.
go back to reference Eisenhardt A, Schneider T, Cruz F, Oelke M (2014) 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. doi:10.1007/s00345-013-1228-7 PubMed Eisenhardt A, Schneider T, Cruz F, Oelke M (2014) 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. doi:10.​1007/​s00345-013-1228-7 PubMed
20.
go back to reference Oelke M, Roehrborn CG, D’Ancona C, Wilson TH, Castro R, Manyak M (2014) Nocturia improvement with dutasteride in phase III studies in men with LUTS/BPH. World J Urol. doi:10.1007/s00345-014-1316-3 Oelke M, Roehrborn CG, D’Ancona C, Wilson TH, Castro R, Manyak M (2014) Nocturia improvement with dutasteride in phase III studies in men with LUTS/BPH. World J Urol. doi:10.​1007/​s00345-014-1316-3
21.
go back to reference Roehrborn CG, Siami P, Barkin J, Damião R, Major-Walker K, Nandy I, Morrill BB, Gagnier RP, Montorsi F, CombAT Study Group (2010) The effects of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: 4-year results from the CombAT study. Eur Urol 57:123–131PubMedCrossRef Roehrborn CG, Siami P, Barkin J, Damião R, Major-Walker K, Nandy I, Morrill BB, Gagnier RP, Montorsi F, CombAT Study Group (2010) The effects of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: 4-year results from the CombAT study. Eur Urol 57:123–131PubMedCrossRef
22.
go back to reference Oelke M, Roehrborn CG, D’Ancona C, Wilson TH, Castro R, Manyak M (2014) Nocturia improvement of Avodart and Tamsulosin (CombAT) study. World J Urol. doi:10.1007/s00345-014-1296-3 Oelke M, Roehrborn CG, D’Ancona C, Wilson TH, Castro R, Manyak M (2014) Nocturia improvement of Avodart and Tamsulosin (CombAT) study. World J Urol. doi:10.​1007/​s00345-014-1296-3
23.
go back to reference Oelke M, Weiss JP, Mamoulakis C, Cox D, Ruff D, Viktrup L (2014) Effects of tadalafil on nighttime voiding (nocturia) in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia: a post hoc analysis of pooled data from four randomized, placebo-controlled clinical studies. World J Urol. doi:10.1007/s00345-014-1255-z Oelke M, Weiss JP, Mamoulakis C, Cox D, Ruff D, Viktrup L (2014) Effects of tadalafil on nighttime voiding (nocturia) in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia: a post hoc analysis of pooled data from four randomized, placebo-controlled clinical studies. World J Urol. doi:10.​1007/​s00345-014-1255-z
24.
go back to reference Bent S, Kane C, Shinohara K, Neuhaus J, Hudes E, Goldberg H et al (2006) Saw palmetto for benign prostatic hyperplasia. N Engl J Med 354:557–566PubMedCrossRef Bent S, Kane C, Shinohara K, Neuhaus J, Hudes E, Goldberg H et al (2006) Saw palmetto for benign prostatic hyperplasia. N Engl J Med 354:557–566PubMedCrossRef
25.
go back to reference Barry MJ, Meleth S, Lee JY, Kreder KJ, Avins AL, Nickel JC et al (2011) Effect of increasing doses of Saw palmetto extract on lower urinary tract symptoms. JAMA 306:1344–1351PubMedCrossRefPubMedCentral Barry MJ, Meleth S, Lee JY, Kreder KJ, Avins AL, Nickel JC et al (2011) Effect of increasing doses of Saw palmetto extract on lower urinary tract symptoms. JAMA 306:1344–1351PubMedCrossRefPubMedCentral
26.
go back to reference van Kerrebroeck P, Abrams P, Chaikin D, Donovan J, Fonda D, Jackson S, Jennum P, Johnson T, Lose G, Mattiasson A, Robertson G, Weiss J (2002) The standardisation of terminology in nocturia: report from the Standardisation Sub-Committee of the International Continence Society. Neurourol Urodyn 21:179–183PubMedCrossRef van Kerrebroeck P, Abrams P, Chaikin D, Donovan J, Fonda D, Jackson S, Jennum P, Johnson T, Lose G, Mattiasson A, Robertson G, Weiss J (2002) The standardisation of terminology in nocturia: report from the Standardisation Sub-Committee of the International Continence Society. Neurourol Urodyn 21:179–183PubMedCrossRef
Metadata
Title
Fixed-dose combination PRO 160/120 of sabal and urtica extracts improves nocturia in men with LUTS suggestive of BPH: re-evaluation of four controlled clinical studies
Authors
Matthias Oelke
Richard Berges
Sandra Schläfke
Martin Burkart
Publication date
01-10-2014
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 5/2014
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-014-1338-x

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