<i>Serenoa repens</i> extract for benign prostate hyperplasia: a randomized controlled trial

Willetts, K.E.; Clements, Mark; Champion, Stephanie; Ehsman, Stuart; Eden, John

doi:10.1046/j.1464-410x.2003.04316.x

Cited by 71 publications

(70 citation statements)

References 20 publications

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“…The overall number of 100 patients was planned. The aim was to find the clinically relevant differences between the treatment groups with changes from the baseline on the total IPSS score of at least 5.6, as previously planned by Willetts et al [7] in a placebo-controlled study on a saw palmetto herbal blend for men with LUTS/BPH.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Tamsulosin Plus Serenoa Repens with Tamsulosin in the Treatment of Benign Prostatic Hyperplasia in Korean Men: 1-Year Randomized Open Label Study

et al. 2015

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Introduction: In Korea, increasing attention has recently been given to the use of phytotherapeutic agents to alleviate the symptoms of BPH. Serenoa repens has been shown to have an equivalent efficacy to Finasteride or Tamsulosin in the treatment of BPH in previous studies. The present study was designed to compare the efficacy and safety of Serenoa repens plus tamsulosin with tamsulosin only over 12 months in men with LUTS secondary to BPH. Materials and Methods: One hundred forty men with symptomatic BPH (IPSS ≥10) were recruited in our hospital for a 12-month, open-label, randomized trial. Patients were randomly assigned to either tamsulosin 0.2 mg/day plus Serenoa repens 320 mg/day (n = 60) or tamsulosin 0.2 mg/day only (n = 60). Prostate volume and PSA were measured at baseline and at end-point, whereas total IPSS, and its storage and voiding subscores, LUTS-related QoL, Qmax, and PVR were evaluated at baseline and later every 6 months. Results: Total 103 patients were finally available: 50 in the TAM + SR group and 53 in the TAM group. At 12 months, total IPSS decreased by 5.8 with TAM + SR and 5.5 with TAM (p = 0.693); the storage symptoms improved significantly more with TAM + SR (-1.7 vs. -0.8 with TAM, p = 0.024). This benefit with regard to storage symptom in the TAM + SR group lasts at 12 months (-1.9 vs. -0.9, p = 0.024). The changes of voiding subscore, LUTS-related QoL, Qmax, PVR, PSA, and prostate volume showed no significant differences between the TAM + SR and TAM groups. During the treatment period, 8 patients (16.9%) with TAM and 10 (20%) with TAM + SR had drug-related adverse reactions, which included ejaculatory disorders, postural hypotension, dizziness, headache, gastro-intestinal disorders, rhinitis, fatigue and asthenia. Conclusions: The combination treatment of Serenoa repens and tamsulosin was shown to be more effective than tamsulosin monotherapy in reducing storage symptoms in BPH patients after 6 months and up to 12 months of treatment.

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Section: Methodsmentioning

confidence: 99%

Comparison of Tamsulosin Plus Serenoa Repens with Tamsulosin in the Treatment of Benign Prostatic Hyperplasia in Korean Men: 1-Year Randomized Open Label Study

et al. 2015

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“…The best described and studied phytotherapeutic agent, Serenoa repens (saw palmetto), has shown mild to moderate efficacy in reducing nocturia, increasing maximal urinary flow and improving International Prostate Symptom Score (IPSS) in men with BPH, 40,41 with results comparable with that of tamsolusin. 40,42,43 However, other trials have shown no significant beneficial effect of S. repens compared with placebo, 44 and a recent Cochrane Review concluded that S. repens was not more effective than placebo for the treatment of urinary symptoms consistent with BPH. 45 Pygeum africanum, an extract from the African prune tree, is another popular alternative remedy for BPH, 46 and has been shown in a Cochrane review to provide moderate relief from the urinary problems caused by BPH.…”

Section: Phytochemicalsmentioning

confidence: 99%

Diagnosis and management of benign prostatic hyperplasia in primary care

Tanguay

Awde

Brock

et al. 2013

CUAJ

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S92colleagues 7 showed that the percentage of men who pursue active treatment, as opposed to watchful waiting, was notably greater for those seen by a urologist regardless of LUTS severity. 4 Urologists and primary care physicians also differed in their choice of therapy. Urologists prescribed 5-alpha-reductase inhibitors (5-ARIs), combination therapy with an alpha-blocker and 5-ARI, and an anticholinergic therapy significantly more often than primary care physicians. 4 Primary care physicians, on the other hand, prescribed nonselective alpha-blockers more often than urologists. 4 It is not apparent why these differences exist, but it is possible that primary care physicians view LUTS mostly as a quality of life (QOL) issue and are less concerned with the progressive nature of the disease. 4 It could also be due to the fact that patients with similar symptoms but who are more bothered about them are referred along to a urology specialist for management. That being said, many feel that a "shared care" approach to the diagnosis and treatment of BPH should be adopted. 3,8 Primary care physicians are better positioned to identify men with LUTS and those at risk for disease progression, and should consider treatment for those men with mild to moderate symptoms without evidence of prostate cancer. In contrast, men with more severe symptoms requiring urgent or emergent treatment (such as surgery) should be seen by a urologist.3 Thus, educating primary care physicians regarding changes in the management of BPH and progression is very important. This article aims to assist physicians in the diagnosis and treatment of BPH in the primary care setting so as to: (1) facilitate access to needed care; (2) improve long-term outcomes of LUTS management and stop the progression of BPH; and (3) avoid surgical consultations in cases where primary care management is sufficient. Diagnosis and management of benign prostatic hyperplasia in primary care REVIEW AbstractBenign prostatic hyperplasia (BPH), and its clinical manifestation as lower urinary tract symptoms (LUTS), is a major health concern for aging men. There have been significant advances in the diagnosis and treatment of BPH in recent years. There has been a renewed interest in medical therapies and less invasive surgical techniques. As a consequence, the treatment needs of men with mild to moderate LUTS without evidence of prostate cancer can now be accomplished in a primary care setting. There are differences in the way urologists and primary care physicians approach the evaluation and management of LUTS due to BPH, which is not reflected in Canadian Urological Association (CUA) and American Urological Association (AUA) guidelines. A "shared care" approach involving urologists and primary care physicians represents a reasonable and viable model for the care of men suffering from LUTS. The essence of the model centres around educating and communicating effectively with the patient on BPH. This article provides primary care physicians with an overview of the diagnostic and m...

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“…Many of the existing papers cover only a short-term follow up of 16 months [Willetts et al 2003;Descotes et al 1995]. More recently, a few studies included a longterm follow up [Pytel et al 2002].…”

Section: Treatment Of Lower Urinary Tract Symptomsmentioning

confidence: 99%

Serenoa repens extract in the treatment of benign prostatic hyperplasia

Geavlete

Multescu

Geavlete

2011

Therapeutic Advances in Urology

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We are experiencing a revival of interest in phytotherapeutic agents, both in Europe and North America, especially as a consequence of patients' dissatisfaction with the adverse effects of the medical alternatives. One of the most frequently prescribed and studied such agents is Serenoa repens extract, derived from the berry of the dwarf palm tree. We aimed to review the most important published data regarding this type of treatment for benign prostatic hyperplasia. A review of the existing articles regarding the use of Serenoa repens extracts for benign prostatic hyperplasia was performed. The articles were analysed with regard to their relevance, scientific value and the size of the evaluated series. Multiple mechanisms of action have been attributed to this extract, including antiandrogenic action, an anti-inflammatory/anti-oedematous effect, prolactin signal modulation, and an antiproliferative effect exerted through the inhibition of growth factors. Regarding efficacy, European Association of Urology guidelines state that Serenoa repens extracts significantly reduce nocturia in comparison with placebo. However, the guideline committee is unable to make specific recommendations about phytotherapy of male lower urinary tract symptoms owing to the heterogeneity of the products and the methodological problems associated with meta-analyses. Most of the published trials regarding Serenoa repens phytotherapy demonstrate a significant improvement of urinary status and a favourable safety profile. Also, some authors have credited it with giving a significant improvement in erectile function and decreasing complications following transurethral resection of the prostate, especially bleeding. The results of phytotherapy with Serenoa repens extracts are very promising. More high-quality, randomized, placebo-controlled studies are required in order to demonstrate without doubt the true therapeutic value of these products. Particular attention must be focused on differentiating between registered preparations, which are regulated as drugs, and those considered to be food supplements.

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Serenoa repens extract for benign prostate hyperplasia: a randomized controlled trial

Cited by 71 publications

References 20 publications

Comparison of Tamsulosin Plus Serenoa Repens with Tamsulosin in the Treatment of Benign Prostatic Hyperplasia in Korean Men: 1-Year Randomized Open Label Study

Comparison of Tamsulosin Plus Serenoa Repens with Tamsulosin in the Treatment of Benign Prostatic Hyperplasia in Korean Men: 1-Year Randomized Open Label Study

Diagnosis and management of benign prostatic hyperplasia in primary care

Serenoa repens extract in the treatment of benign prostatic hyperplasia

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