Can we use baseline characteristics to assess which men with moderately symptomatic benign prostatic hyperplasia at risk of progression will benefit from treatment? A post hoc analysis of data from the 2-year CONDUCT study

Abstract

PurposeTo investigate (in a post hoc analysis of the 2-year CONDUCT study) the characteristics and clinical outcomes of men with moderately symptomatic benign prostatic hyperplasia (BPH) at risk of progression who benefitted from lifestyle changes alone.MethodsPatients were given lifestyle advice and randomized to a fixed-dose combination (FDC) of dutasteride and tamsulosin or watchful waiting (WW) and followed for 24 months. Patients in the WW group were escalated to tamsulosin if any follow-up International Prostate Symptom Score (IPSS) was equal or greater than the baseline value. Improvements in symptoms (change in IPSS) and quality of life [measured by BPH Impact Index (BII) and question 8 of the IPSS (IPSS-Q8)] were analysed in the FDC group, men who initiated tamsulosin (WW-TAM) and men who received no medical intervention (WW-no treatment) and the impact of baseline variables on IPSS determined.ResultsThe adjusted mean decrease in IPSS, BII and IPSS-Q8 at each post-baseline visit over 24 months appeared greater in the FDC (n = 369) and WW-no treatment groups (n = 144) than in the WW-TAM group (n = 229). IPSS improvements appeared similar in the FDC group and WW-no treatment subgroup, except in patients with the greatest degree of bother at baseline (BII 7–13).ConclusionBII at baseline may be a more relevant indicator than symptom severity as to whether a patient with moderate symptoms should receive medical therapy or not.

A Scientometric Visualization Analysis for Benign Prostatic Hyperplasia from 2016 to 2022

“…During these 6 years, the most active researchers were Roehrborn CG, Zorn KC, and Chughtai B. Roehrborn CG was major about PUL surgery and sexual function [ 29 ], focusing on aquablation surgery of the prostate [ 30 ], and using baseline characteristics to assess if the men could get benefit from potential treatments [ 31 ]. Zorn K.C.…”

Monocentric single‐arm study of desmopressin acetate efficacy on nocturnal polyuria in the elderly

“…The answers are assigned points from 0 to 5. The total symptom score can, therefore, range from 0 to 35: mild (symptom score less than or equal to 7), moderate (symptom score range 8‐19) and severe (symptom score range 20‐35) 44‐46 …”

Is Early Surgical Treatment for Benign Prostatic Hyperplasia Preferable to Prolonged Medical Therapy: Pros and Cons

“…In the CONDUCT study, one third of the patients treated with watchful waiting (WW) plus lifestyle advices alone had an improvement of BPH symptoms as measured by improvement of IPSS score. A post-hoc analysis of the latter showed that WW plus lifestyle advices had similar efficacy to combination therapy of ARAs and 5ARIs in terms of IPSS score improvement, except for patients with heavy symptoms at baseline (Benign Prostatic Hyperplasia Impact Index [BII] 7–13) [ 39 ]. The lifestyle advices provided in this study were about caffeine and alcohol avoidance, bladder retraining, fluid management and avoidance of constipation [ 35 ].…”