Long‐term efficacy and safety of alfuzosin 10 mg once daily: a 2‐year experience in ‘real‐life’ practice

Elhilali, Mostafa; Emberton, Mark; Matzkin, Haim; Moorselaar, R. Jeroen A. van; Härtung, R.; Harving, Niels; Alcaraz, Antonio; Vallancien, Guy

doi:10.1111/j.1464-410x.2005.05962.x

Cited by 41 publications

(32 citation statements)

References 28 publications

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“…ED was reported in 65% of men, reduced ejaculate in 63% and painful ejaculation in 20%. There were significant improvements in weighted scores of all three variables after 1 year of alfuzosin (Figure 3), findings further confirmed by their group using the Brief Sexual Function Inventory questionnaire at 2-year follow-up [29].…”

Section: Management Of Luts/bph: Implications For Sdsupporting

confidence: 78%

Treating Coexistent Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms and Erectile Dysfunction in the Aging Male

2007

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Both lower urinary tract symptoms associated with benign prostatic hyperplasia and erectile dysfunction are highly prevalent in the aging male population, a prevalence that increases with age. Evidence now suggests there is an independent association between these two complaints, increasing the likelihood that men presenting with either will suffer coexistent benign prostatic hyperplasia/lower urinary tract symptoms and erectile dysfunction. Treating these men presents both pitfalls and opportunities to the physician. By treating pathophysiological pathways common to both, whilst avoiding medication adversely affecting sexual function, optimal improvements in symptomatology and quality of life can be achieved. This review examines the relationship between these two pathologies and the implications for pharmacological intervention.Lower urinary tract symptoms (LUTS) affect over 50% of the male population aged over 60 years, an incidence which increases with age and is largely attributed to benign prostatic hyperplasia (BPH).Incidence of sexual dysfunction (SD) is also particularly high in this group of patients, and is increasingly recognized as a source of significant concern and loss of quality of life, even within older age groups [1]. SD incorporates not only erectile dysfunction (ED), but also impairment of other components of sexual function such as ejaculation, orgasm, sexual drive and sexual satisfaction, factors considered highly significant to overall sexual function.These two conditions were originally thought to be independent of each other and attributed to aging, but recent studies suggest an association underpinned by a common pathophysiological etiology.This has important implications for the management of men with either BPH/LUTS or ED, and particularly for those with both. Medical intervention for either condition affects the other, with potential for both exacerbation and improvement of symptoms [2]. An understanding of both disease states is therefore important in the treatment of either and is reviewed here, along with common treatment options. Association between LUTS & SD EpidemiologyIn 1996, Macfarlane surveyed a sample of the French population [3], noting low sexual life satisfaction scores with increasing age and severity of LUTS, and found the association persisted even after controlling for age. These findings have been confirmed by subsequent studies (such as the UrEpik study [4] and the Cologne Male Survey [5]), which demonstrate that LUTS are independent risk factors for ED.The clinical significance of this association was underscored when the Alf-One study group also reported a relationship between ED and LUTS severity in clinic attendees [6]. In this group of men, with relatively high mean age and LUTS severity, they found a high prevalence of ED (62%), and identified age and LUTS as the main predictors of the condition.However, perhaps the most important study to date to examine this has been the Multinational Survey of the Aging Male [7]. This large, multinational survey gathered...

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Section: Management Of Luts/bph: Implications For Sdsupporting

confidence: 78%

Treating Coexistent Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms and Erectile Dysfunction in the Aging Male

2007

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“…The long-term effectiveness of alfuzosin 10 mg once daily treatment in men with LUTS/BPH has been demonstrated in an open-label extension phase of a 3-month pivotal study (Van Kerrebroeck et al 2002), in a 2-year clinical-practice study (ALF-ONE; (Elhilali et al 2006)), and a 2-year study of BPH clinical progression (ALTESS; (Roehrborn 2006a)). In the ALFORTI pivotal study (Van Kerrebroeck et al 2002), patients randomized to receive alfuzosin 10 mg once daily or alfuzosin 2.5 mg 3 times daily during the double-blind phase received alfuzosin 10 mg for up to 9 months in the extension phase, whereas patients randomized to receive placebo during the double-blind phase received alfuzosin 10 mg for up to 9 months in the extension phase.…”

Section: Alfuzosin Clinical Efficacymentioning

confidence: 99%

“…In the ALF-ONE study (Elhilali et al 2006), in which the efficacy and safety of alfuzosin 10 mg once daily were evaluated in men with LUTS/BPH in a clinical-practice setting over a 2-year period, LUTS improved 39% and disease-specific quality of life improved 43% from baseline (both p < 0.0001; Table 2). The majority of men reported symptom relief within 2 weeks of treatment initiation that was maintained throughout the study.…”

Section: Alfuzosin Clinical Efficacymentioning

confidence: 99%

Medical therapy options for aging men with benign prostatic hyperplasia: focus on alfuzosin 10 mg once daily

Roehrborn¹

2008

CIA

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Lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) are common in aging men and can signifi cantly affect quality of life. Men with bothersome LUTS/BPH often present with various other age-related conditions, including sexual dysfunction, heart disease, hypertension, diabetes, and the metabolic syndrome, which can complicate management decisions. Therefore, healthcare providers should be familiar with fi rst-line treatment options for LUTS/BPH and their differing safety profi les, particularly with respect to cardiovascular and sexual function side effects. This article presents a review of fi rst-line medical therapy options for managing aging men with LUTS/BPH and patient considerations when evaluating and selecting these therapies, with a focus on the clinical effi cacy and cardiovascular and sexual function safety profi les of the uroselective α 1 -adrenergic receptor antagonist alfuzosin 10 mg once daily. Alfuzosin improves LUTS, peak urinary fl ow rates, and disease-specifi c quality of life, reduces the long-term risk of overall BPH progression, and is well tolerated in aging men, with minimal vasodilatory and sexual function side effects, even in those with comorbidities. Alfuzosin is well tolerated when used in combination with antihypertensive medications and phosphodiesterase type 5 inhibitors for the treatment of erectile dysfunction. The long-term clinical effi cacy and good cardiovascular and sexual function safety profi le of alfuzosin can contribute to an improved quality of life for aging men with LUTS/BPH.

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“…However, preliminary data suggest that treatment of the symptoms of BPH with some a-blockers may also improve ED and EjD. [33][34][35][36][37] Finally, data from a study of sildenafil suggested an improvement in LUTS in men being treated for ED. 38 As additional knowledge is gained on the mechanisms involved in the association between LUTS and SD, as well as other age-related diseases (e.g., hypertension, hyperlipidemia, diabetes mellitus and depression), 39 and as existing and new treatment options are evaluated, evidencebased management guidelines for these concomitant conditions should evolve.…”

Section: Physician Perceptions Of Sexual Dysfunction In Bphmentioning

confidence: 99%

Physician perceptions of sexual dysfunction related to benign prostatic hyperplasia (BPH) symptoms and sexual side effects related to BPH medications

2007

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In a large-scale epidemiology study, 50% of aging men reported erectile dysfunction (ED) or ejaculatory dysfunction (EjD), with lower urinary tract symptoms (LUTS) an independent risk factor for each of these conditions. In light of the shift from urologists (UROs) to primary care/ internal medicine physicians (PCPs) for the initial management of men with LUTS associated with benign prostatic hyperplasia (BPH), a survey was conducted to assess the perceptions of UROs and PCPs regarding sexual dysfunction (SD) in men with LUTS/BPH and the effects of BPH treatments (a 1 -adrenergic receptor antagonists (a-blockers) and 5a-reductase inhibitors (5ARIs)) on sexual function. The survey was mailed to 7500 UROs and 2500 PCPs, with 1275 (13%) surveys returned (1087 by UROs, 177 by PCPs and 11 by other specialty). a-Blocker monotherapy was the most common medication prescribed by both UROs (56%) and PCPs (47%). UROs estimated that 19% of their patients with LUTS/BPH experienced SD owing to their symptoms compared with the estimate of 27% by PCPs. UROs estimated that 19% of their patients experienced SD owing to their BPH medication compared with the PCP estimate of 24%. The incidence of EjD owing to BPH medications estimated by UROs (32%) was higher than that estimated by PCPs (22%); the rate of ED estimated by PCPs (34%) was higher than that estimated by UROs (23%). UROs were more aware than PCPs of the specific sexual side effects caused by a-blockers versus 5ARIs. These results suggest that physicians are underestimating the prevalence of SD in men with LUTS/BPH. As men with LUTS/ BPH are at increased risk for SD, physicians should be especially cognizant of BPH treatmentrelated sexual side effects.

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Long‐term efficacy and safety of alfuzosin 10 mg once daily: a 2‐year experience in ‘real‐life’ practice

Cited by 41 publications

References 28 publications

Treating Coexistent Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms and Erectile Dysfunction in the Aging Male

Treating Coexistent Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms and Erectile Dysfunction in the Aging Male

Medical therapy options for aging men with benign prostatic hyperplasia: focus on alfuzosin 10 mg once daily

Physician perceptions of sexual dysfunction related to benign prostatic hyperplasia (BPH) symptoms and sexual side effects related to BPH medications

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