Efficacy and tolerability of combination therapy with alpha-blockers and phosphodiesterase-5 inhibitors compared with monotherapy for lower urinary tract symptoms

Liu, Qiangzhao; Zhang, Xiaofeng; Zhou, Fenghai; Lian, Qiong; Zhang, Fa; Bohong, Guo; Xi, Xinsheng

doi:10.1097/md.0000000000022834

Cited by 7 publications

(4 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Tadalafil by itself has been shown to lower IPSS total score, voiding subscore, and storage subscore in men ≥ 40 years [ 14 ]. Several studies have shown that combination therapy of PDE5I’s and alpha blockers work better than either drug alone in managing LUTS due to BPH [ 15 , 16 ]. The order of drug administration does not have any significant effects [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Is tadalafil associated with decreased risk of major adverse cardiac events or venous thromboembolism in men with lower urinary tract symptoms?

et al. 2022

View full text Add to dashboard Cite

Purpose To evaluate the association of tadalafil, a phosphodiesterase-5 inhibitor (PDE5I), with major adverse cardiac events (MACE) or venous thromboembolism (VTE) in men with lower urinary tract symptoms (LUTS). Methods Data was obtained from the TriNetX Research Network, ICD-10 codes were used to identify men with LUTS, MACE, and VTE. In addition, demographic characteristics and use of tadalafil or alpha-blocker was evaluated. Then, unbalanced and balanced association analyses was performed to assess the relation between tadalafil and/or alpha-blocker use with MACE/VTE. Results After participant selection, analysis included 821,592 men that did not use an alpha blocker or tadalafil, 5,004 men that used tadalafil but no alpha blocker, 327,482 men that used an alpha blocker but no tadalafil, and 6,603 men that used both an alpha blocker and tadalafil. On balanced analysis, tadalafil was independently associated with a decreased risk of MACE/VTE within a 3-year time period (OR = 0.59, 95%CI 0.49–0.70, p < 0.0001). Among men with a history of alpha blocker use, tadalafil use was also independently associated with a decreased risk of MACE or VTE, both before and after controlling for potentially confounding variables (OR = 0.57, 95%CI: 0.50–0.66; p < 0.0001). Conclusions In our study, tadalafil was associated with a decreased risk of MACE/VTE in men with LUTS with and without a history of alpha blocker use. It is time to perform further long-term prospective randomized studies to further analyze the cardiovascular effects of PDE5Is as combination treatment with alpha blockers in the management of LUTS. Supplementary Information The online version contains supplementary material available at 10.1007/s00345-022-04005-3.

show abstract

Section: Discussionmentioning

confidence: 99%

Is tadalafil associated with decreased risk of major adverse cardiac events or venous thromboembolism in men with lower urinary tract symptoms?

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Specifically, vardenafil and alpha blockers ranked higher than sildenafil and tadalafil combinations. Importantly, this combination was found to be more effective at improving LUTS compared to alpha-blockers alone [ 18 ]. Several trials have been conducted to assess the use of antimuscarinics in BPH as either single-line monotherapy or combination therapy with an alpha blocker such as terazosin.…”

Section: Reviewmentioning

confidence: 99%

Pharmacological Approaches in Managing Symptomatic Relief of Benign Prostatic Hyperplasia: A Comprehensive Review

O'Quin,

White,

Campbell

et al. 2023

Cureus

View full text Add to dashboard Cite

Benign Prostatic Hyperplasia (BPH) is a prevalent condition that affects aging men, leading to the development of lower urinary tract symptoms (LUTS) and potentially severe complications such as complete obstruction. The management of BPH typically involves the use of medications from different classes, including alpha-1 antagonists, 5-alpha reductase inhibitors, and anticholinergics. Combination therapy utilizing drugs from different classes can also effectively manage the BPH-LUTS complex. Recent research has revealed that phosphodiesterase 5 (PDE5) inhibitors, including Tadalafil and Sildenafil, are highly effective in treating LUTS associated with BPH. Tadalafil as a monotherapy has recently been shown to significantly improve LUTS in BPH patients. Additionally, the use of herbal remedies as a treatment option for BPH has also been widely debated. Previous research suggests that saw palmetto can reduce BPH symptoms through several proposed mechanisms, but recent trials have found inconsistencies in its efficacy. In this literature review, we conducted an extensive PubMed database search to provide current and comprehensive insights into BPH treatment options. This review comprehensively evaluates available treatments for managing BPH, highlighting the effectiveness of different classes of medications and combination therapies in managing associated symptoms. The present investigation also discusses recent research on the efficacy of PDE5 inhibitors in treating LUTS associated with BPH and the uncertain efficacy of herbal remedies. The insights provided by this study can guide healthcare professionals in making informed decisions about managing BPH, ultimately improving patient outcomes.

show abstract

“…Studies have shown that combination therapy with PDE5 is and alpha-blockers provided better outcomes than a-adrenergic blocker monotherapy. 4 Several metaanalyses have defined the efficacy and safety of PDE5 is alone or in combination with α1-blockers for the treatment of BPH-LUTS. Moreover, the combination therapy can significantly improve international prostate symptom score (IPSS) and maximal flow rate (Qmax).…”

Section: Effectiveness Of Tadalafil and Tamsulosin Combination In Ben...mentioning

confidence: 99%

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

Sudarsan S,

Prabhu T,

Rajsri TR

et al. 2023

Asian J Med Sci

View full text Add to dashboard Cite

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.

show abstract

Efficacy and tolerability of combination therapy with alpha-blockers and phosphodiesterase-5 inhibitors compared with monotherapy for lower urinary tract symptoms

Cited by 7 publications

References 28 publications

Is tadalafil associated with decreased risk of major adverse cardiac events or venous thromboembolism in men with lower urinary tract symptoms?

Is tadalafil associated with decreased risk of major adverse cardiac events or venous thromboembolism in men with lower urinary tract symptoms?

Pharmacological Approaches in Managing Symptomatic Relief of Benign Prostatic Hyperplasia: A Comprehensive Review

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

Contact Info

Product

Resources

About