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International Urology and Nephrology

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10-02-2023 | Benign Prostatic Hypertrophy | Urology - Original Paper

Clinical outcomes of withdrawing one medication from long-term combination therapy comprising α-blocker and 5α-reductase inhibitor for benign prostatic hyperplasia

Authors: Jae Duck Choi, Tag Keun Yoo, Jung Yoon Kang, Hyuk-Dal Jung, Jun Ho Lee

Published in: International Urology and Nephrology | Issue 4/2023

Abstract

Purpose

To assess adherence to combination therapy comprising α-adrenergic blocker (AB) and 5α-reductase inhibitor (5ARI) for benign prostatic hyperplasia (BPH) in a real-world setting and whether lower urinary tract symptoms (LUTS) will relapse after discontinuing one medication from long-term combination therapy.

Methods

BPH/LUTS patients receiving initial AB +5ARI combination therapy for at least 1 year between January 2012 and January 2017 were retrospectively analyzed. The patients were classified into DC-AB group (n = 65, AB discontinued) and DC-5ARI group (n = 77, 5ARI discontinued) and followed up. Clinical effects were assessed at baseline and annually using the International Prostatic Symptoms Score (IPSS), quality of life (QoL) index, total prostate volume (TPV), maximal flow rate (Qmax), and prostate-specific antigen (PSA) level.

Results

Of total 1783 patients, 809 (45.4%) patients were identified with more than 1-year combination therapy. After withdrawal of one medication from combination therapy, the TPV progression (27.6% vs. − 10.8%; P < 0.001) and the requirement for prostate surgery (14.3% vs. 6.1%; P = 0.038) were significantly higher in the DC-5ARI group than in the DC-AB group. The rate of resuming combination therapy was significantly higher in the DC-5ARI group than in the DC-AB group (38.9% vs. 23.0%; P = 0.009).

Conclusions

Adherence to combination BPH therapy is relatively low. Although patients adhered to combination therapy for more than 1 year, a higher risk of requiring prostate surgery or resuming combination therapy was observed in patients who discontinued 5ARI.

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Title: Clinical outcomes of withdrawing one medication from long-term combination therapy comprising α-blocker and 5α-reductase inhibitor for benign prostatic hyperplasia
Authors: Jae Duck Choi
Tag Keun Yoo
Jung Yoon Kang
Hyuk-Dal Jung
Jun Ho Lee
Publication date: 10-02-2023
Publisher: Springer Netherlands
Keywords: Benign Prostatic Hypertrophy
Prostate Surgery
Benign Prostatic Hypertrophy
Dutasteride
Published in: International Urology and Nephrology / Issue 4/2023
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-023-03476-6

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Abstract

Purpose

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Conclusions

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