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Yoosuf BT, Panda AK, Kt MF, Bharti SK, Devana SK, Bansal D. Comparative efficacy and safety of alpha-blockers as monotherapy for benign prostatic hyperplasia: a systematic review and network meta-analysis. Sci Rep 2024; 14:11116. [PMID: 38750153 PMCID: PMC11096304 DOI: 10.1038/s41598-024-61977-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/13/2024] [Indexed: 05/18/2024] Open
Abstract
Despite the availability of various drugs for benign prostatic hyperplasia (BPH), alpha(α)-blockers are the preferred first-line treatment. However, there remains a scarcity of direct comparisons among various α-blockers. Therefore, this network meta-analysis (NMA) of randomized controlled trials (RCTs) aimed to evaluate the efficacy and safety of α-blockers in the management of BPH. A comprehensive electronic search covered PubMed, Embase, Ovid MEDLINE, and Cochrane Library until August 2023. The primary endpoints comprised international prostate symptom score (IPSS), maximum flow rate (Qmax), quality of life (QoL), and post-void residual volume (PVR), while treatment-emergent adverse events (TEAEs) were considered as secondary endpoints. This NMA synthesized evidence from 22 studies covering 3371 patients with six kinds of α-blockers with 12 dose categories. IPSS has been considerably improved by tamsulosin 0.4 mg, naftopidil 50 mg and silodosin 8 mg as compared to the placebo. Based on the p-score, tamsulosin 0.4 mg had the highest probability of ranking for IPSS, PVR, and Qmax, whereas doxazosin 8 mg had the highest probability of improving QoL. A total of 297 adverse events were reported among all the α-blockers, silodosin has reported a notable number of TEAEs. Current evidence supports α-blockers are effective in IPSS reduction and are considered safer. Larger sample size with long-term studies are needed to refine estimates of IPSS, QoL, PVR, and Qmax outcomes in α-blocker users.
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Affiliation(s)
- Beema T Yoosuf
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), S.A.S. Nagar, Mohali, Punjab, India
| | - Abhilash Kumar Panda
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), S.A.S. Nagar, Mohali, Punjab, India
| | - Muhammed Favas Kt
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), S.A.S. Nagar, Mohali, Punjab, India
| | - Saroj Kundan Bharti
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), S.A.S. Nagar, Mohali, Punjab, India
| | - Sudheer Kumar Devana
- Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Dipika Bansal
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), S.A.S. Nagar, Mohali, Punjab, India.
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Shin D, Yoon BI, Kim S, Piao J, Jeon KH, Kwon Y, Park SH, Koo YT, Kim JS, Lee DS, Ha US, Kim SW, Jang H, Bae WJ. Cervi Parvum Cornu complex for men with lower urinary tract symptoms: a multicenter, randomized, double-blind, placebo-controlled trial. Prostate Int 2023; 11:222-227. [PMID: 38196553 PMCID: PMC10772165 DOI: 10.1016/j.prnil.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/21/2023] [Accepted: 09/04/2023] [Indexed: 01/11/2024] Open
Abstract
Background To evaluate the efficacy and safety of Cervi Parvum Cornu, Angelicae Gigantis Radix and Glycyrrhizae Radix complex (CAG) in men with moderate lower urinary tract symptoms (LUTS). Materials and methods From November 2020 to January 2022, participants with International Prostate Symptom Score (IPSS) of 12-19 in two centers were recruited and randomize into three groups: a CAG 500 mg/day group (CAG 500), a CAG 1000 mg/day group (CAG 1000), and a placebo group (PG). They were treated for 12 weeks. The primary endpoint was change of IPSS at the end of study from baseline. Secondary end points included change of prostate specific antigen (PSA), testosterone, dihydrotestosterone (DHT), maximum urinary flow rate (Q max), post-void residual volume (PVR), International Index of Erectile Function (IIEF), and drug safety. Results A total of 103 patients were able to finish the study according to the study protocol. Total IPSS and sub-scores (residual urine sensation, frequency, weak stream, hesistancy, nocturia, and quality of life) in CAG 500 and CAG 1000 were significantly improved at the 12th week compared to those of the PG. Changes of serum PSA, DHT, and testosterone levels at the 12th week from baseline did not show significant differences among the three groups. Q max and PVR changes did not show significant differences among the three groups either. Total IIEF and sub-scores (erectile function, orgasmic function, sexual desire, intercourse satisfaction) in CAG 1000 were significantly improved at 12th week compared to those in PG. No significant adverse events were found. Conclusions CAG is well tolerated in patients with moderate LUTS. Treatment with CAG for 12 weeks has a therapeutic effect on moderate LUTS.
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Affiliation(s)
- Dongho Shin
- Department of Urology, College of Medicine, Catholic Kwandong University, Incheon, Korea
| | - Byung Il Yoon
- Department of Urology, College of Medicine, Catholic Kwandong University, Incheon, Korea
| | - Soomin Kim
- Catholic Integrative Medicine Research Institute, The Catholic University of Korea, Seoul, Korea
| | - JunJie Piao
- Catholic Integrative Medicine Research Institute, The Catholic University of Korea, Seoul, Korea
| | - Kyung-Hwa Jeon
- College of Pharmacy, Ewha Womans University, Seoul, Korea
| | - Youngjoo Kwon
- College of Pharmacy, Ewha Womans University, Seoul, Korea
| | - Sang-Hyuck Park
- Institute of Cannabis Research, Colorado State University Pueblo, Pueblo, CO, USA
| | | | - Jin-Soo Kim
- Kwang Dong Pharmaceutical Co, Ltd., Seoul, Korea
| | - Dong Sup Lee
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - U-Syn Ha
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sae Woong Kim
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Catholic Integrative Medicine Research Institute, The Catholic University of Korea, Seoul, Korea
- Green Medicine Co., Ltd, Pusan, Korea
| | - Hoon Jang
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Woong Jin Bae
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Catholic Integrative Medicine Research Institute, The Catholic University of Korea, Seoul, Korea
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Lee JH, Park YW, Park MH, Yoo TK. Safety and efficacy of tamsulosin 0.4 mg as an initial dose in 1,219 Korean patients with moderate to severe lower urinary tract symptoms: data from a phase IV study. Prostate Int 2023; 11:228-232. [PMID: 38196556 PMCID: PMC10772215 DOI: 10.1016/j.prnil.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/10/2023] [Accepted: 09/19/2023] [Indexed: 01/11/2024] Open
Abstract
Background An initial dose of tamsulosin 0.2 mg is frequently prescribed for Asian men. We investigated the safety and efficacy of tamsulosin 0.4 mg as the initial dose in Korean men with moderate to severe lower urinary tract symptoms (LUTSs) in everyday clinical practice. Materials and methods A phase IV study was conducted in South Korea. Eligible patients were prescribed tamsulosin 0.4 mg for 6 months. We excluded patients with previous exposure to LUTS drugs and patients with an international prostate symptom score (IPSS) < 8. Results The mean total IPSS, storage subscore, voiding symptoms subscore, and quality of life significantly decreased from 18.0, 10.8, 7.2, and 3.8 to 12.8, 7.5, 5.3, and 2.6, respectively, after 6 months of treatment. The number of nocturia episodes significantly decreased from 3.0 to 2.2 in patients who reported at least 2 nocturia events at baseline. A mean reduction in the IPSS was quantitatively equivalent in all age groups. The mean reduction in the IPSS was greater in the IPSS ≥ 20 group than in the IPSS < 20 group (mean reduction in the total IPSS: -2.6 in the IPSS < 20 group; -9.4 in the IPSS ≥ 20 group). All treatment-emergent adverse events were mild. The most frequently recorded treatment-emergent adverse event was dizziness, which was reported in 22 patients (1.8%). Conclusion Treatment of LUTS with tamsulosin 0.4 mg as the initial dose for 6 months in Korean men was effective in improving LUTS and showed a favorable safety profile in a real-life setting.
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Affiliation(s)
- Jun Ho Lee
- Department of Urology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - Yeon Won Park
- Department of Urology, National Police Hospital, Seoul, Korea
| | | | - Tag Keun Yoo
- Department of Urology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
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Shin D, Zhu GQ, Tian WJ, Ahn ST, Jeon SH, Cho HJ, Ha US, Hong SH, Lee JY, Kim SW, Moon DG, Bae WJ. Quisqualis indica extract for men with lower urinary tract symptoms: A randomized, double-blind, placebo-controlled trial. Investig Clin Urol 2023; 64:20-30. [PMID: 36629062 PMCID: PMC9834572 DOI: 10.4111/icu.20220290] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/08/2022] [Accepted: 11/27/2022] [Indexed: 12/28/2022] Open
Abstract
PURPOSE To evaluate the efficacy and safety of Quisqualis indica in men with moderate lower urinary tract symptoms (LUTS). MATERIALS AND METHODS A total of 135 subjects with International Prostate Symptom Score (IPSS) of 8-19 were randomized in 2 centers from June 2018 to April 2019. Patients were assigned into one of the three groups: a low-dose group (LG, 1,000 mg Q. indica), a high-dose group (HG, 2,000 mg Q. indica) or a placebo group (PG). The primary endpoint was the change of IPSS at the end of treatment from baseline. Secondary end points included the changes of prostate specific antigen, testosterone, dihydrotestosterone, maximum urinary flow rate (Qmax), postvoid residual volume (PVR) and International Index of Erectile Function-5 (IIEF-5), with drug safety. RESULTS 113 patients were able to finish the study. Compared to the PG, total IPSS in the LG and the HG was significantly improved at 6 weeks and 12 weeks. For IPSS subscores, LG showed improvements in all except for urgency and quality of life at 6 weeks. HG showed improvements in incomplete emptying and frequency at 6 weeks and 12 weeks along with improvements in intermittency, straining, and quality of life at 12 weeks. For IIEF-5 subscores, orgasmic function and overall satisfaction improved in HG when compared to PG at 12 weeks. Lastly, increase of Qmax and decrease of PVR was observed at 6 weeks in LG. CONCLUSIONS 12-week treatment with Q. indica has a therapeutic effect and is well tolerated in patients with LUTS.
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Affiliation(s)
- Dongho Shin
- Department of Urology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Guan Qun Zhu
- Catholic Integrative Medicine Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Department of Urology, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Wen Jie Tian
- Catholic Integrative Medicine Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sun Tae Ahn
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Seung Hwan Jeon
- Catholic Integrative Medicine Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyuk Jin Cho
- Department of Urology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - U-Syn Ha
- Department of Urology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung-Hoo Hong
- Department of Urology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ji Youl Lee
- Department of Urology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sae Woong Kim
- Department of Urology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Catholic Integrative Medicine Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Du Geon Moon
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Woong Jin Bae
- Department of Urology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Catholic Integrative Medicine Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Bapir R, Bhatti KH, Eliwa A, García-Perdomo HA, Gherabi N, Hennessey D, Magri V, Mourmouris P, Ouattara A, Perletti G, Philipraj J, Trinchieri A, Buchholz N. Effect of alpha-adrenoceptor antagonists on sexual function. A systematic review and meta-analysis. Arch Ital Urol Androl 2022; 94:252-263. [PMID: 35775356 DOI: 10.4081/aiua.2022.2.252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Alpha-adrenoreceptor antagonists or alpha-blockers are used in the treatment of hypertension, in the therapy of benign prostatic hyperplasia and in medical expulsive treatment of ureteral stones. These agents may affect the sexual function, with differences between drugs within the same class, depending on their selectivity for receptor subtypes. The aim of this review was to analyze the effects of alpha-blockers on sexual function. MATERIALS AND METHODS We conducted a systematic review and meta-analysis by searching PubMed, EMBASE and other databases for randomized controlled trials (RCTs) reporting sexual adverse effects in patients treated with alpha-blockers. Odds ratios for sexual dysfunction were calculated using random effects Mantel-Haenszel statistics. RESULTS Out of 608 records retrieved, 75 eligible RCTs were included in the meta-analysis. Compared with placebo, alphablockers were associated with increased odds of ejaculatory disorders both in patients with lower urinary tract symptoms (LUTS) associated to benign prostatic hyperplasia (BPH) (OR: 7.53, 95% CI: 3.77-15.02, Z = 5.73, p < 0.00001, I2 = 55%) and in patients with ureteral stones (OR: 2.88, 95% CI: 1.50-5.44, Z = 3.19, p < 0.001, I2 = 31%). Uroselective alpha-blockers showed higher odds of ejaculatory disorders. Conversely, nonselective alpha-blockers were not associated with higher odds of ejaculatory dysfunction. Silodosin was associated with increased odds of ejaculatory dysfunction compared with tamsulosin (OR: 3.52, 95% CI: 2.18-5.68, 15 series, 1512 participants, Z = 5.15, p < 0.00001, I2 = 0%). Naftopidil and alfuzosin showed lower odds of ejaculatory dysfunction compared to uroselective alpha-blockers.No statistically significant differences in the odds of erectile dysfunction were observed when alpha-blockers were compared to placebo.
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Affiliation(s)
- Rawa Bapir
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; and Smart Health Tower, Sulaymaniyah, Kurdistan region.
| | - Kamran Hassan Bhatti
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; and Urology Department, HMC, Hamad Medical Corporation.
| | - Ahmed Eliwa
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; and Department of Urology, Zagazig University, Zagazig, Sharkia.
| | | | - Nazim Gherabi
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; and Faculty of Medicine Algiers 1, Algiers.
| | - Derek Hennessey
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; and Department of Urology, Mercy University Hospital, Cork.
| | - Vittorio Magri
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; and ASST Nord Milano, Milan.
| | - Panagiotis Mourmouris
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; and 2nd Department of Urology, National and Kapodistrian University of Athens, Sismanoglio Hospital, Athens.
| | - Adama Ouattara
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; and Division of Urology, Souro Sanou University Teaching Hospital, Bobo-Dioulasso.
| | - Gianpaolo Perletti
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; and Department of Biotechnology and Life Sciences, Section of Medical and Surgical Sciences, University of Insubria, Varese.
| | - Joseph Philipraj
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; and Department of Urology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry.
| | - Alberto Trinchieri
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; and Urology School, University of Milan.
| | - Noor Buchholz
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; and Sobeh's Vascular and Medical Center, Dubai Health Care City, Dubai.
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Fan Z, Shi H, Zhang J, Wang H, Wang J. Comparative Efficacy of Different Drugs for Lower Urinary Tract Symptoms due to Benign Prostatic Hyperplasia: A Bayesian Network Meta-Analysis. Front Pharmacol 2022; 13:763184. [PMID: 35330833 PMCID: PMC8940212 DOI: 10.3389/fphar.2022.763184] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 02/17/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) are common in middle-aged and elderly men. The current drugs for treating this disease include α1-adrenoceptor antagonists (ABs), muscarinic receptor antagonists (MRAs), phosphodiesterase five inhibitors (PDE5-Is), and β3-adrenoceptor agonists (B3As). However, direct comparative studies analyzing different therapies are limited; therefore, we conducted a network meta-analysis (NMA) to evaluate the efficacy of different drug regimens for treating BPH/LUTS. Methods: The PubMed, EMbase, Web of Science, and Cochrane Library databases were searched to collect randomized controlled trials (RCTs) of different drug treatments for BPH/LUTS from January 2000 to April 2021. The NMA was performed using R 4.1 software. Results: Fifty-five RCTs were included among a total of 1639 trials. ① ABs + PDE5-Is, ABs + B3As, ABs + MRAs, ABs, and PDE5-IS were superior to the placebo in improving the total International Prostate Symptom Score (IPSS), IPSS-Voiding, and IPSS-storage. ② For increasing the maximum flow rate (Qmax), ABs + PDE5-Is, ABs + MRAs, and ABs were more effective than the placebo. ③ Regarding reducing post-void residual urine (PVR), none of the six treatment plans had significant effects. Conclusion: Combination therapy showed greater efficacy than monotherapy, and ABs + PDE5-Is was the most successful treatment for improving the overall IPSS score. ABs are a primary therapeutic measure to increase Qmax, and ABs + PDE5-I may be a more suitable choice for enhancing Qmax. The combination of MRA and AB+ MRA may lead to an increase in PVR. Systematic Review Registration: [website], identifier [registration number].
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Affiliation(s)
- Zhinan Fan
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Hongjin Shi
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jinsong Zhang
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Haifeng Wang
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jiansong Wang
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
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Lulic Z, Son H, Yoo SB, Cunnington M, Kapse P, Miller D, Cortes V, Park S, Bhak RH, Duh MS. Free combination of dutasteride plus tamsulosin for the treatment of benign prostatic hyperplasia in South Korea: analysis of drug utilization and adverse events using the National Health Insurance Review and Assessment Service database. BMC Urol 2021; 21:178. [PMID: 34933674 PMCID: PMC8691067 DOI: 10.1186/s12894-021-00941-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 11/29/2021] [Indexed: 11/21/2022] Open
Abstract
Objective To assess the use and safety of free combination therapy (dutasteride and tamsulosin), dutasteride monotherapy, or tamsulosin monotherapy in patients with benign prostatic hyperplasia (BPH). Methods This non-interventional retrospective cohort study used claims data from the Korea Health Insurance Review and Assessment-National Patient Sample database. Patients with BPH ≥ 40 years of age receiving combination therapy (dutasteride 0.5 mg and tamsulosin 0.4 mg daily) or dutasteride 0.5 mg, or tamsulosin 0.4 mg daily dose between 2012 and 2017 were included. The frequency, duration of treatment and risk of any adverse event (AE) or serious AE (SAE) was compared for combination therapy versus each monotherapy using non-inferiority testing. Results Of 14,755 eligible patients, 1529 (10.4%) received combination therapy, 6660 (45.1%) dutasteride monotherapy, and 6566 (44.5%) tamsulosin monotherapy. The proportion of patients treated with combination therapy exceeded the pre-specified 3% threshold for ‘frequent’ use. Safety results indicated a similar risk of any AE and SAE irrespective of treatment group. The adjusted relative risk for any AE over the treatment observation period comparing combination therapy with dutasteride monotherapy was 1.07 (95% confidence interval [CI] 1.03, 1.12), and with tamsulosin monotherapy was 0.98 (95% CI 0.95, 1.02) demonstrating non-inferiority. The adjusted relative risk for any SAE was 1.07 (95% CI 0.66, 1.74) and 0.90 (95% CI 0.56, 1.45), compared with dutasteride and tamsulosin monotherapy, respectively. Although the SAE results did not statistically demonstrate non-inferiority of combination therapy based on pre-specified margins, the 95% CI for the risk ratio estimates included the null with a lower limit below the non-inferiority margins, indicating no meaningful differences in SAE risk between groups. Absolute SAE risks were low. Conclusion Combination therapy with dutasteride and tamsulosin is frequently used in real-world practice in South Korea for treatment of BPH and demonstrates a safety profile similar to either monotherapy. Supplementary Information The online version contains supplementary material available at 10.1186/s12894-021-00941-1.
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Affiliation(s)
| | - Hwancheol Son
- Department of Urology, Seoul National University College of Medicine, Boramae Hospital, Seoul, Korea
| | | | | | | | | | | | - Suna Park
- Analysis Group, Inc., Boston, MA, USA
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Ban MS, Kim YK, Kim B, Jung J, Kim YI, Oh J, Yu KS. Evaluation of the pharmacokinetics and food effects of a novel formulation tamsulosin 0.4 mg capsule compared with a 0.2 mg capsule in healthy male volunteers. Transl Clin Pharmacol 2021; 28:181-188. [PMID: 33425801 PMCID: PMC7781808 DOI: 10.12793/tcp.2020.28.e17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 09/28/2020] [Accepted: 10/06/2020] [Indexed: 11/19/2022] Open
Abstract
Tamsulosin, an alpha-1 adrenoreceptor antagonist, has been used as a primary option for medical treatment of benign prostate hyperplasia. An open-label, single-dose, randomized, three-treatment, three-period, three sequence crossover study was conducted to evaluate the pharmacokinetics (PKs) of 0.2 and 0.4 mg tamsulosin hydrochloride (HCl) in the fed versus the fasted state. Subjects were randomly assigned to three sequences and received one of the following treatments at each period: tamsulosin HCl 0.2 or 0.4 mg in the fed state with a high-fat meal, or tamsulosin HCl 0.4 mg in the fasted state. Blood samples for the PK analysis were collected at pre-dose and up to 48 h post-dose. The PK parameters were calculated by a non-compartmental method. The geometric mean ratio (GMR) and its 90% confidence intervals (CIs) of the plasma maximum concentration (Cmax) and area under concentration curve from time zero to last measurable concentration (AUClast) were calculated. Twenty-two subjects completed the study. The systemic exposure of tamsulosin 0.4 mg decreased approximately 9% in the fed state compared to the fasted state, and the time to reach peak concentration was slightly delayed in the fed state. The dose normalized GMR and its 90% CIs of Cmax and AUClast for 0.2 and 0.4 mg tamsulosin in the fed state were within 0.8 and 1.25 range. Systemic exposure of tamsulosin was decreased in the fed condition compared to the fasted condition. Linear PK profiles were observed between 0.2 and 0.4 mg tamsulosin in the fed state. Trial Registration ClinicalTrials.gov Identifier: NCT02529800.
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Affiliation(s)
- Mu Seong Ban
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul 03080, Korea
| | - Yu Kyong Kim
- Department of Clinical Pharmacology and Therapeutics, Chungbuk National University College of Medicine and Hospital, Cheongju 28644, Korea
| | - Byungwook Kim
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul 03080, Korea
| | - Jina Jung
- Hanmi Pharmaceutical Co., Seoul 05637, Korea
| | - Yong-Il Kim
- Hanmi Pharmaceutical Co., Seoul 05637, Korea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul 03080, Korea
| | - Kyung-Sang Yu
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul 03080, Korea
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