Impact of Therapy Used in Clinical Practice on Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia (LUTS/BPH) Disease Progression

Berges, Richard

doi:10.1016/j.eursup.2003.09.004

Cited by 12 publications

(4 citation statements)

References 17 publications

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“…The risk of treatment failure (defined as the need for catheterization assuming AUR, or switch to other therapy or surgery) appears to be lower in a practice database with tamsulosin therapy than with alfuzosin, doxazosin, or terazosin when using finasteride as a reference therapy [9]. Tamsulosin is associated with a greater risk of retrograde ejaculation and usually is not a cost issue, but occasionally results in a switch of therapy.…”

Section: α1-adrenergic Receptor Antagonistsmentioning

confidence: 99%

The economics of medical therapy for lower urinary tract symptoms associated with benign prostatic hyperplasia

Nickel

2006

Curr Urol Rep

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Medical therapy is currently the most popular treatment choice for lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). Because medical therapy of BPH-related LUTS is considered a life-long strategy, short- and long-term cost considerations should play a major role in therapeutic decision-making. The effectiveness in terms of long and short amelioration of symptoms, flow rate, and quality of life are well documented for 5alpha-blockers and 5alpha-reductase inhibitors as well as for the gold standard treatment for BPH, transurethral resection of the prostate and minimally invasive therapies. Short- and long-term safety concerns also are well documented for these various treatment options. On the contrary, short- and long-term costs have been less well studied and comparisons depend on the model or analyses undertaken in the few studies available. However, the economic studies based on prospective clinical trial data that have become available throughout the past several decades allow us to rationalize our use of alpha- blockers, 5alpha-reductase inhibitors, and combination therapy, taking into consideration age, severity of symptoms, prostate volume, prostate-specific antigen, and the differential response of the various medications (and combination) in selected patients. Based on current studies, 5alpha-blockers generally provide cost-effective therapy for most patients, whereas 5alpha-reductase therapy and combination therapy provide cost-effective treatment for patients with larger prostate glands or higher baseline prostate-specific antigen levels.

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Section: α1-adrenergic Receptor Antagonistsmentioning

confidence: 99%

The economics of medical therapy for lower urinary tract symptoms associated with benign prostatic hyperplasia

Nickel

2006

Curr Urol Rep

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show abstract

“…Tamsulosin is associated with a greater risk of retrograde ejaculation and usually is not a cost issue, but occasionally results in a switch of therapy. The risk of treatment failure (defined as the need for catheterization assuming AUR, or switch to other therapy or surgery) appears to be lower in a practice database with tamsulosin therapy than with alfuzosin, doxazosin, or terazosin when using finasteride as a reference therapy [9]. Another retrospective review [10] with a 3-year follow-up demonstrated a significantly lower rate of re-treatment with tamsulosin (27%) compared with either alfuzosin (37%) or terazosin (49%).…”

Section: α1-adrenergic Receptor Antagonistsmentioning

confidence: 94%

The economics of medical therapy for lower urinary tract symptoms associated with benign prostatic hyperplasia

Nickel¹

2006

Curr prostate rep

View full text Add to dashboard Cite

Medical therapy is currently the most popular treatment choice for lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). Because medical therapy of BPH-related LUTS is considered a life-long strategy, short-and long-term cost considerations should play a major role in therapeutic decision-making. The effectiveness in terms of long and short amelioration of symptoms, flow rate, and quality of life are well documented for 5α-blockers and 5α-reductase inhibitors as well as for the gold standard treatment for BPH, transurethral resection of the prostate and minimally invasive therapies. Short-and long-term safety concerns also are well documented for these various treatment options. On the contrary, short-and long-term costs have been less well studied and comparisons depend on the model or analyses undertaken in the few studies available. However, the economic studies based on prospective clinical trial data that have become available throughout the past several decades allow us to rationalize our use of α-blockers, 5α-reductase inhibitors, and combination therapy, taking into consideration age, severity of symptoms, prostate volume, prostate-specific antigen, and the differential response of the various medications (and combination) in selected patients. Based on current studies, 5α-blockers generally provide cost-effective therapy for most patients, whereas 5α-reductase therapy and combination therapy provide cost-effective treatment for patients with larger prostate glands or higher baseline prostate-specific antigen levels.

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“…α Blockers α Blockers are recommended as first-line agents in patients with an enlarged prostate less than 40 g in size and bothersome LUTS [Berges, 2003;Lepor, 1998b]. α Blockers decrease bladder outlet resistance provided by urethral smooth muscle and possibly striated sphincter tone to alleviate LUTS [Milani and Djavan, 2005].…”

Section: Phytotherapymentioning

confidence: 99%

“…Men with an enlarged prostate and minimal clinical symptoms as per the IPSS (≤7) can often be observed [Berges, 2003]. These men can be advised about behavioral modifications, including fluid restriction, timed voiding, and double voiding.…”

Section: Treatment Optionsmentioning

confidence: 99%

Experience with the combination of dutasteride and tamsulosin in the long-term management of benign prostatic hyperplasia

Chughtai

Lee

et al. 2012

Therapeutic Advances in Urology

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Lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) commonly affect older men. These bothersome symptoms can lead to a decreased quality of life. Currently, two classes of drugs - α-adrenergic blockers and 5α-reductase inhibitors - are prescribed to treat LUTS secondary to BPH. Due to their different mechanisms of action, these medications work in a synergistic manner. Trials of combination therapy have been conducted to assess its effect compared with monotherapy. Current data support combination therapy in men with moderately enlarged prostates and moderate to severe symptoms.

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Impact of Therapy Used in Clinical Practice on Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia (LUTS/BPH) Disease Progression

Cited by 12 publications

References 17 publications

The economics of medical therapy for lower urinary tract symptoms associated with benign prostatic hyperplasia

The economics of medical therapy for lower urinary tract symptoms associated with benign prostatic hyperplasia

The economics of medical therapy for lower urinary tract symptoms associated with benign prostatic hyperplasia

Experience with the combination of dutasteride and tamsulosin in the long-term management of benign prostatic hyperplasia

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