Impact of baseline symptom severity on future risk of benign prostatic hyperplasia-related outcomes and long-term response to finasteride

Kaplan, Steven A.; Garvin, Dennis D.; Gilhooly, Patricia; Koppel, M. A. X.; Labasky, Richard F.; Milsten, Richard; Reddy, Pratap K.; Rosenberg, Steven; Sussman, David; White, C Michael; Lee, Michael; Pappas, Frances; Waldstreicher, Joanne

doi:10.1016/s0090-4295(00)00724-x

Cited by 46 publications

(24 citation statements)

References 27 publications

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“…What are these parameters? It has been shown in many publications that the response to a-blockers and 5-ARIs is similarly independent of the patient's age and even symptom severity at the beginning of treatment, 26,27 although the adverse events reported with different a-blockers may vary with age. 28,29 Breaking down the LUTS into irritative/ storage vs obstructive/voiding symptoms may help to some degree in distinguishing responses to 5-ARIs but not necessarily to a-blockers, which reduce all symptoms to an equal degree.…”

Section: Serum Psa and Response To Medical Therapymentioning

confidence: 99%

The utility of serum prostatic-specific antigen in the management of men with benign prostatic hyperplasia

Roehrborn

2008

Int J Impot Res

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Several analyses have demonstrated a clinically useful relationship between serum prostate specific antigen (PSA) and prostate volume in men with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). Both prostate volume and serum PSA predict certain aspects of the natural history of LUTS and BPH, and men with higher PSA and larger glands in general have a higher rate of progression measured by various parameters. Serum PSA also predicts the response to certain types of medical therapy in men with LUTS and BPH and is thus useful in the evaluation and management of these patients. Lastly, serum PSA does not loose its usefulness as a cancer marker for prostate cancer even if certain medications reduce serum PSA values predictably by 50%.

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Section: Serum Psa and Response To Medical Therapymentioning

confidence: 99%

The utility of serum prostatic-specific antigen in the management of men with benign prostatic hyperplasia

Roehrborn

2008

Int J Impot Res

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“…The drugs considered for the analyses were fi nasteride, doxazosine or combinations, based on randomized clinical trials (10)(11)(12)(13) and Brazilian health system reality (less costly).…”

Section: Economic Analysismentioning

confidence: 99%

Cost-effectiveness analysis of medical treatment of benign prostatic hyperplasia in the Brazilian public health system

et al. 2012

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ARTICLE INFO _________________________________________________________ ___________________Objective: To perform a cost-effectiveness analysis of medical treatment of benign prostatic hyperplasia (BPH) under Brazilian public health system perspective (Unified Health System -"Sistema Único de Saúde (SUS)"). Material and Methods:A revision of the literature of the medical treatment of BPH using alpha-blockers, 5-alpha-reductase inhibitors and combinations was carried out. A panel of specialists defined the use of public health resources during episodes of acute urinary retention (AUR), the treatment and the evolution of these patients in public hospitals. A model of economic analysis(Markov) predicted the number of episodes of AUR and surgeries (open prostatectomy and transurethral resection of the prostate) related to BPH according to stages of evolution of the disease. Brazilian currency was converted to American dollars according to the theory of Purchasing Power Parity (PPP 2010: US$ 1 = R$ 1.70). Results: The use of finasteride reduced 59.6% of AUR episodes and 57.9% the need of surgery compared to placebo, in a period of six years and taking into account a treatment discontinuity rate of 34%. The mean cost of treatment was R$ 764.11 (US$449.78) and R$ 579.57 (US$ 340.92) per patient in the finasteride and placebo groups, respectively. The incremental cost-effectiveness ratio (ICERs) was R$ 4.130 (US$ 2.429) per episode of AUR avoided and R$ 2.735 (US$ 1.609) per episode of surgery avoided. The comparison of finasteride + doxazosine to placebo showed a reduction of 75.7% of AUR episodes and 66.8% of surgeries in a 4 year time horizon, with a ICERs of R$ 21.191 (US$ 12.918) per AUR episodes avoided and R$ 11.980 (US$ 7.047) per surgery avoided. In the sensitivity analysis the adhesion rate to treatment and the cost of finasteride were the main variables that influenced the results. Conclusions: These findings suggest that the treatment of BPH with finasteride is costeffective compared to placebo in the Brazilian public health system perspective.

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“…In the same study, the incidence of AUR was also correlated to the baseline symptom score, but not as prominently. 57 It should be noted that the baseline symptom score, however, is generally not a risk factor for disease progression. This can be attributed in some ways to the difficulty for men with high symptom scores to have a four-point or greater symptom score decrease.…”

Section: Symptom Scorementioning

confidence: 99%

Voiding dysfunction in men: pathophysiology and risk factors

Scofield

Kaplan

2008

Int J Impot Res

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Impact of baseline symptom severity on future risk of benign prostatic hyperplasia-related outcomes and long-term response to finasteride

Cited by 46 publications

References 27 publications

The utility of serum prostatic-specific antigen in the management of men with benign prostatic hyperplasia

The utility of serum prostatic-specific antigen in the management of men with benign prostatic hyperplasia

Cost-effectiveness analysis of medical treatment of benign prostatic hyperplasia in the Brazilian public health system

Voiding dysfunction in men: pathophysiology and risk factors

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