Sustained-Release Alfuzosin, Finasteride and the Combination of Both in the Treatment of Benign Prostatic Hyperplasia

Debruyne, F.M.J.; Jardin, A; Colloi, D.; Resel, Luis; Witjes, Wim P.J.; Delauche–Cavallier, M. C.; McCarthy, Caitlin; Geffriaud-Ricouard, Christine

doi:10.1159/000019706

Cited by 213 publications

(169 citation statements)

References 16 publications

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“…[78][79][80][81] The Alfuzosin-Finasteride (ALFIN) study demonstrated that alfuzosin had little or no impact on sexual function, whereas finasteride and combination therapy (alfuzosin and finasteride) caused impairment of erectile and ejaculatory function. 82,83 These findings have also been replicated in the larger scale, placebo-controlled Medical Therapy of Prostatic Symptoms study. 79 Impact of pharmacological treatment of ED on LUTS: PDE5 inhibitors Four possible pathophysiologic mechanisms have been described that may explain a potential role of PDE5-inhibitor therapy in LUTS.…”

Section: Luts and Ed: Effects On Clinical Managementmentioning

confidence: 81%

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management

2011

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There is strong evidence from multiple epidemological studies that lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are correlated, independent of age or comorbidities as diabetes or hypertension. Although a direct causal relationship is not established yet, four pathophysio logical mechanisms can explain the relationship. These include alteration in nitric oxide bioavailability, a1-adrenergic receptor hyperactivity, pelvic atherosclerosis and sex hormones. This association has different clinical implications on the management of both disorders. Men seeking care for one condition should always be screened for complaints of the other condition. Sexual function should be assessed and discussed with the patient when choosing the appropriate management strategy for LUTS, as well as when evaluating the patient's response to treatment. Multiple large clinical trials have shown an improvement in LUTS after phosphodiesterase-5 (PDE5)-inhibitor treatment. PDE5 inhibitors show promise as a future treatment for LUTS, either in conjunction with existing therapies or as a primary treatment. There may be a potential therapeutic role for testosterone in LUTS treatment in cases of testosterone deficiency that needs to be investigated. Much further investigation is required, but it is evident that the association between LUTS and ED is fundamental for future therapies and possible preventative strategies.

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Section: Luts and Ed: Effects On Clinical Managementmentioning

confidence: 81%

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management

2011

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“…It can however be expected that similar results will be obtained, since two relatively short-term comparative studies (6 ± 12 months) between ®nasteride and a 1 -adrenoceptor antagonists indicate that a 1 -adrenoceptor antagonists are at least as good as ®nasteride in terms of disease progression, ie reduction of the development of acute urinary retention and/or the need for surgery. 5,6 Within the group of a 1 -adrenoceptor antagonists, alfuzosin is the most prescribed compound among French GPs in prevalent LUTS cases, but tamsulosin prescription growth may indicate that it will soon take the leading position in the future (Figures 1 and 2a). Tamsulosin already is the most frequently prescribed drug in new LUTS patients in 1998.…”

Section: Discussionmentioning

confidence: 99%

Treatment of lower urinary tract symptoms suggestive of benign prostatic obstruction in real life practice in France

Vallancien

Pariente

2001

Prostate Cancer Prostatic Dis

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The objective of this work is to describe the pro®le of prevalent and incident populations suffering from lower urinary tract symptoms (LUTS) suggestive of benign prostatic obstruction (BPO) and to analyse the management of care by 620 general practitioners (GPs) in France in 1997 and 1998. Patient records were extracted from the THALES database. Special attention was given to the use of medical therapy and switch rates (ie change to another or combination with another drug). In real life practice (RLP) French GPs predominantly utilise a 1 -adrenoceptor antagonists for the treatment of LUTS. This is in agreement with available evidence from randomised controlled trials (RCTs) with different medical therapies (a 1 -adrenoceptor antagonists, ®nasteride, plant extracts). On the contrary, the relatively high usage of phytotherapy might be explained by traditional and personal preferences. Using purely descriptive statistics, newer a 1 -adrenoceptor antagonists, alfuzosin and tamsulosin, seem to be the most frequently prescribed medical therapy for new patients and are, moreover, associated with a low switch rate. Prostate Cancer and Prostatic Diseases (2001) 4, 124±131.

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“…Figure 4 Improvement in sexual score in patients with severe symptoms after 1 y of treatment with alfuzosin. 39,40 …”

Section: Resultsmentioning

confidence: 99%

“…The ALFIN Study in addition to comparing the efficacy of alfuzosin and finasteride and their combination in BPH, also examined the effect of these therapies on erection and ejaculation using the DAN-PSS questionnaire. 39,40 A total of 1051 patients aged 50 -75 y were enrolled in the study. The effects of therapy on ED and ejaculatory function are shown in Figures 1 and 2.…”

Section: Medical Therapymentioning

confidence: 99%

“…The effects of therapy on ED and ejaculatory function are shown in Figures 1 and 2. 39,40 Results showed that alfuzosin had very little effect on the ability to achieve an erection, whereas erectile function decreased with finasteride therapy and with the combination of the two drugs, presumably due to the contribution of finasteride. With regard to ejaculation, again, only finasteride and the combination had a detrimental effect.…”

Section: Medical Therapymentioning

confidence: 99%

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Impact of treatment of BPH on sexuality

Schulman

2001

Prostate Cancer Prostatic Dis

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Benign prostatic hyperplasia (BPH) can have a profound affect on a patient's quality of life and sexual function and is considered by patients to be one of the most important aspects affected by the disease. Different treatments can produce a variable response in terms of the patient's quality of life, including sexual activity and satisfaction. Varying rates of erectile dysfunction (ED) and retrograde ejaculation following surgery for BPH have been reported. In general, the incidence of these side-effects is less after minimally invasive therapies, such as interstitial laser coagulation and transurethral microwave therapy, but the data available are limited. The lowest rates of sexual dysfunction are reported with medical therapies. The 5a-reductase inhibitor, finasteride, can result in ED in 5 -9% of patients and ejaculation disorders in 0.8 -2.0%. With the exception of tamsulosin, a 1 blockers are associated with a low rate of sexual dysfunction. No cases of ED have been reported with alfuzosin and abnormal ejaculation with terazosin or alfuzosin is negligible. Indeed, early research suggests a beneficial effect of a 1 blockers on sexual function. In addition to information on the efficacy of a particular therapy, patients should be informed of side effects, in particular those relating to sexual function, in order that they can make informed treatment decisions. Prostate Cancer and Prostatic Diseases (2001) 4, Suppl 1, S12-S16.

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Sustained-Release Alfuzosin, Finasteride and the Combination of Both in the Treatment of Benign Prostatic Hyperplasia

Cited by 213 publications

References 16 publications

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management

Treatment of lower urinary tract symptoms suggestive of benign prostatic obstruction in real life practice in France

Impact of treatment of BPH on sexuality

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