The effects of combination therapy with dutasteride plus tamsulosin on clinical outcomes in men with symptomatic BPH: 4-year post hoc analysis of European men in the CombAT study

Abstract

CombAT (Combination of Avodart and Tamsulosin) was a randomised, double-blind study in men (n ¼ 4844) aged X50 years with a clinical diagnosis of BPH. Patients were randomised to daily tamsulosin 0.4 mg, dutasteride 0.5 mg or both for 4 years. The primary endpoint was time to acute urinary retention (AUR) or BPH-related surgery. Secondary endpoints included BPH clinical progression, symptoms and maximum urinary flow rate. A post hoc analysis of data from the European subgroup was conducted. A total of 2925 men were randomised to treatment in Europe as part of CombAT (tamsulosin, n ¼ 972; dutasteride, n ¼ 970; combination, n ¼ 983). Combination therapy significantly reduced the relative risk of AUR or BPH-related surgery compared with either monotherapy at 4 years, and also significantly reduced the risk of BPH clinical progression. Combination therapy also provided significantly greater symptom improvement than either monotherapy at 4 years. Safety and tolerability of dutasteride plus tamsulosin was consistent with previous experience of this combination and with the monotherapies. These data provide further evidence to support the use of long-term combination therapy (dutasteride plus tamsulosin) in men with moderate-to-severe lower urinary tract symptoms because of BPH and prostatic enlargement. The results in the European subgroup are generally consistent with those in the overall study population.

Inhibitory Effect of Silodosin, Tamsulosinand Terazosin in Phenylephrine Induced-Prostate Smooth Muscle Contraction (a Comparative in vitro Study)

“…One of the LUTS symptoms pathophysiology in BPH patients is increased in smooth muscle tone of the prostate. Selective α1adrenergic receptor antagonist is chosen as a therapy for BPH because it is effective and safe for long-term use [7][8][9][10]. These drugs act on the dynamic component of Bladder Outlet Obstruction (BOO), that reduce smooth muscle tone of the prostate and bladder neck [11].…”

Effect of Improvement in Lower Urinary Tract Symptoms on Sexual Function in Men: Tamsulosin Monotherapy vs. Combination Therapy of Tamsulosin and Solifenacin

“…However, LUTS are divided into voiding symptoms and storage symptoms. α-Blockers and 5-androgen receptor inhibitors are an effective medication for men with LUTS [10,11]. However, these medications are not sufficient for managing all patients with LUTS, because LUTS originate not only from pathologic benign prostatic hyperplasia also as a result of a detrusor muscle condition [12].…”

Effect of Discontinuation of Tamsulosin in Korean Men with Benign Prostatic Hyperplasia Taking Tamsulosin and Dutasteride: An Open‐Label, Prospective, Randomized Pilot Study

“…Combination therapy was shown to lead to greater reductions in storage subscores than dutasteride monotherapy and tamsulosin monotherapy from months 3 and 12, respectively. Recently a 4‐year post hoc analysis of the CombAT data showed that combination therapy also provided significantly greater symptom improvement than either monotherapy at 4 years 19 …”

“…Recently a 4-year post hoc analysis of the CombAT data showed that combination therapy also provided significantly greater symptom improvement than either monotherapy at 4 years. 19 Jeong et al examined the effect of discontinuing 5ARIs on prostate volume and symptoms in BPH patients. 20 They divided the patients into two groups giving combination therapy with either finasteride 5 mg or dutasteride 0.5 mg.…”