Severity profiles in patients diagnosed of benign prostatic hyperplasia in Spain

Miñana, B.; Rodrı́guez-Antolı́n, A.; Prieto, M.; Pedrosa, E.

doi:10.1016/j.acuroe.2013.03.003

Cited by 3 publications

(13 citation statements)

References 16 publications

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“…The CONDUCT study was the first to investigate the single-capsule combination of dutasteride and tamsulosin in men with moderate symptoms of BPH at risk of progression [1,24]. Restricting the study population to men with moderate symptoms was based on the understanding that, especially in an open-label study, men with severe symptoms should ideally receive active intervention at the time of diagnosis rather than have a delay of at least 4 weeks before initiation.…”

Section: Discussionmentioning

confidence: 99%

“…The IPSS is a seven-item questionnaire that quantitatively measures the level of urinary symptoms reported as a total IPSS. The total IPSS can range from 0 to 35 and classifies BPH symptoms into mild (0-7), moderate (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19), or severe (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)). An additional, independent eighth question (IPSS-Q8) was added to assess self-perceived QoL and BPH-related health status.…”

Section: Methodsmentioning

confidence: 99%

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Efficacy and safety of a fixed‐dose combination of dutasteride and tamsulosin treatment (Duodart^®) compared with watchful waiting with initiation of tamsulosin therapy if symptoms do not improve, both provided with lifestyle advice, in the management of treatment‐naïve men with moderately symptomatic benign prostatic hyperplasia: 2‐year CONDUCT study results

Roehrborn

Perez²,

Roos

et al. 2015

BJU International

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ObjectiveTo investigate whether a fixed-dose combination (FDC) of 0.5 mg dutasteride and 0.4 mg tamsulosin is more effective than watchful waiting with protocol-defined initiation of tamsulosin therapy if symptoms did not improve (WW-All) in treatment-naïve men with moderately symptomatic benign prostatic hyperplasia (BPH) at risk of progression. Patients and MethodsThis was a multicentre, randomised, open-label, parallel-group study (NCT01294592) in 742 men with an International Prostate Symptom Score (IPSS) of 8-19, prostate volume ≥30 mL and total serum PSA level of ≥1.5 ng/mL. Patients were randomised to FDC (369 patients) or WW-All (373) and followed for 24 months. All patients were given lifestyle advice. The primary endpoint was symptomatic improvement from baseline to 24 months, measured by the IPSS. Secondary outcomes included BPH clinical progression, impact on quality of life (QoL), and safety. ResultsThe change in IPSS at 24 months was significantly greater for FDC than WW-All (-5.4 vs −3.6 points, P < 0.001). With FDC, the risk of BPH progression was reduced by 43.1% (P < 0.001); 29% and 18% of men in the WW-All and FDC groups had clinical progression, respectively, comprising symptomatic progression in most patients. Improvements in QoL (BPH Impact Index and question 8 of the IPSS) were seen in both groups but were significantly greater with FDC (P < 0.001). The safety profile of FDC was consistent with established profiles of dutasteride and tamsulosin. ConclusionFDC therapy with dutasteride and tamsulosin, plus lifestyle advice, resulted in rapid and sustained improvements in men with moderate BPH symptoms at risk of progression with significantly greater symptom and QoL improvements and a significantly reduced risk of BPH progression compared with WW plus initiation of tamsulosin as per protocol.Keywords benign prostatic hyperplasia, dutasteride, fixed-dose combination, lower urinary tract symptoms, tamsulosin, watchful waiting [Correction added on 13 February 2015 after first online publication: The trademark symbol for 'Duodart' has been changed to a registered symbol]

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Efficacy and safety of a fixed‐dose combination of dutasteride and tamsulosin treatment (Duodart^®) compared with watchful waiting with initiation of tamsulosin therapy if symptoms do not improve, both provided with lifestyle advice, in the management of treatment‐naïve men with moderately symptomatic benign prostatic hyperplasia: 2‐year CONDUCT study results

Roehrborn

Perez²,

Roos

et al. 2015

BJU International

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“…Benign prostatic hyperplasia (BPH) is a progressive, non-malignant overgrowth of the prostate gland commonly observed in men over 50 years of age. 1,2 By obstructing urinary flow, BPH frequently causes lower urinary tract symptoms (LUTS), which are a significant burden in ageing men, and have a major negative impact on quality of life (QoL); it also increases the risk of disease progression. 1,[3][4][5][6][7] Although BPH is the most common cause of LUTS, other possible causes exist; therefore, comprehensive assessment facilitating an accurate diagnosis of BPH as a cause of LUTS is crucial.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 By obstructing urinary flow, BPH frequently causes lower urinary tract symptoms (LUTS), which are a significant burden in ageing men, and have a major negative impact on quality of life (QoL); it also increases the risk of disease progression. 1,[3][4][5][6][7] Although BPH is the most common cause of LUTS, other possible causes exist; therefore, comprehensive assessment facilitating an accurate diagnosis of BPH as a cause of LUTS is crucial. [8][9][10][11] As per clinical guidelines in Spain, the following assessments are mandatory: clinical history, physical exam, digital rectal exam (DRE) and urinalysis; and the following assessments are recommended: prostate-specific antigen (PSA) and International Prostate Symptom Score (IPSS).…”

Section: Introductionmentioning

confidence: 99%

“…18 The most highly predictive measures for disease progression are age, LUTS severity, decreased urinary flow, prostatic enlargement and PSA (progression criteria defined as IPSS ≥ 8; prostate volume >30 cc and PSA ≥ 1.5 ng/mL). 1,15,[19][20][21] Progression criteria are prevalent in patients with BPH, with many men already showing signs of progression at diagnosis. 1 With the natural age-related progression of the disease and an ageing population, an increase in the prevalence of BPH and its associated social and economic impact on healthcare is foreseeable.…”

Section: Introductionmentioning

confidence: 99%

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Real‐world assessment and characteristics of men with benign prostatic hyperplasia (BPH) in primary care and urology clinics in Spain

Molero

Miñana

Palacios‐Moreno

et al. 2020

Int. J. Clin. Pract.

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Real‐world therapeutic management and evolution of patients with benign prostatic hyperplasia in primary care and urology in Spain

et al. 2021

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Objectives: This study aimed to describe the real-world therapeutic management of patients with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) (LUTS/BPH) attending primary care and urology clinics in Spain.Methods: This observational, retrospective, multicentre study included men ≥50 years of age diagnosed with LUTS/BPH (≤8 years prior to study visit) (N = 670).Therapeutic management according to healthcare service (primary care vs. urology clinics) or progression criteria, proportion of patients with treatment change, patient profile according to therapy and evolution of LUTS severity were assessed.Results: Overall differences were noticed in the management of patients between healthcare service (P < .001) and with or without progression criteria (P < .05). Most patients received pharmacological treatment at diagnosis (70.7%; 474/670), which increased at study visit (81.6%; 547/670) with overall similar profiles between primary care and urology clinics for each therapy. α1-Blockers were the most used pharmacological treatment across healthcare settings at diagnosis (61.8%; 293/474) and study visit (51%; 279/547). Only 27.1% (57/210) of patients with progression criteria at diagnosis and 35.6% (99/278) at study visit received 5α-reductase inhibitor (5ARI) alone or in combination with a α1-blocker. Overall, most patients did not change treatment (60%; 402/670) with a trend of more patients worsening in symptoms when not receiving α1-blocker plus 5ARI combination therapy. Conclusion:Most patients with LUTS/BPH received pharmacological treatment; however, most men with progression criteria did not receive a 5ARI alone or in combination. These results support the need to reinforce both primary care and urologists existing clinical guideline recommendations for the appropriate medical management of patients with LUTS/BPH.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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Severity profiles in patients diagnosed of benign prostatic hyperplasia in Spain

Cited by 3 publications

References 16 publications

Real‐world assessment and characteristics of men with benign prostatic hyperplasia (BPH) in primary care and urology clinics in Spain

Real‐world therapeutic management and evolution of patients with benign prostatic hyperplasia in primary care and urology in Spain

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