Drug treatment patterns for the management of men with lower urinary tract symptoms associated with benign prostatic hyperplasia who have both storage and voiding symptoms: a study using the health improvement network UK primary care data

Abstract

Background: Real-world data on the pharmacological management of men who have lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) are limited.

A retrospective study of treatment persistence and adherence to α-blocker plus antimuscarinic combination therapies, in men with LUTS/BPH in the Netherlands

“…Previously reported data from a large, retrospective observational cohort study of 8694 men with LUTS/BPH in the UK showed that fewer patients discontinued (43.0% vs. [mean] 53.0%) or switched treatment (15.3% vs. [mean] 22.0%) from solifenacin compared with most other antimuscarinics, and persisted on-treatment for longer (median duration, 90 days vs. [range] 30–116 days) [16]. These findings are supported by further real-world data in patients with OAB, suggesting that solifenacin provides greater treatment persistence compared with other antimuscarinics (mean persistence 187 vs. 77–157 days; persistence at 12 months, 35% vs. 14%–28%) [24].…”

“…However, the pattern of prescriptions across the antimuscarinics was more balanced in these studies, suggesting that the proportion of patients prescribed with solifenacin in the current study (74.4%) may be specific to the Netherlands. Regarding α-blockers, tamsulosin is reported to be the most commonly used for LUTS/BPH [16], but it should also be noted that the impact of individual α-blockers used in combination on persistence, adherence or switching were not assessed in the same way as antimuscarinics in this study; this could perhaps be evaluated in further studies.…”

“…the extent to which a patient acts in accordance with the prescribed interval, and dose of a dosing regimen [15]) are reported to be low in men with LUTS/BPH. An observational study of 8694 men ≥45 years of age with LUTS/BPH conducted in the United Kingdom (UK) showed that 38.5% and 53.0% of men discontinued α-blocker and antimuscarinic therapy, respectively, over a median duration of 2.1 years’ treatment [16]; and a retrospective study of 670 men with LUTS/BPH in Korea found that approximately two-thirds of men discontinued an α-blocker, a 5-ARI, or both treatments in combination within 1 year of starting treatment) [17]. In the latter study, adverse events (AEs) were among the most common reasons for discontinuation and for switching of treatment.…”

Safety, efficacy, and persistence of long‐term mirabegron treatment for overactive bladder in the daily clinical setting: Interim (1‐year) report from a Japanese post‐marketing surveillance study

“…Historically, oral antimuscarinic agents have been the mainstay of OAB therapy, although the associated side‐effects (including dry mouth and constipation) further affect quality of life and adversely affect treatment adherence . Treatment persistence of OAB medication is lower than for any other chronic disease therapy, with a number of studies demonstrating poor treatment persistence with antimuscarinics . As such, OAB treatments with alternative mechanisms of action and improved tolerability are desirable.…”

Efficacy and safety of various drugs used for the treatment of nonneurogenic lower urinary tract symptoms in tertiary care hospital

“…The most commonly prescribed α₁-blocker was tamsulosin (81.8%); and most frequent antimuscarinics was Tolterodine (41.0%). 6 The efficacies of all drugs were assessed on the basis of mean change difference in IPSS score, Qmax, and Qavg.…”