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Kosilov K, Kuzina I, Kuznetsov V, Barabash O, Fedorishcheva E. Efficacy of a combination of dutasteride, tadalafil, and solifenacin in the treatment of previously unsuccessful patients. Asian J Urol 2022; 9:42-50. [PMID: 35198395 PMCID: PMC8841250 DOI: 10.1016/j.ajur.2021.04.002] [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: 07/08/2019] [Revised: 07/15/2020] [Accepted: 09/09/2020] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE To evaluate the efficacy and safety of simultaneous administration of dutasteride, tadalafil and solifenacin in the treatment of benign prostatic hyperplasia (BPH) with overactive bladder symptoms and lower urinary tract obstruction in previously unsuccessfully treated men. METHODS Patients in Group A (n=97) received dutasteride 0.5 mg/day, tadalafil 2.5 mg/day, and solifenacin 2.5 mg/day; Group B (n=95) received dutasteride 0.5 mg/day, tadalafil 5 mg/day, and solifenacin 5 mg/day; Group C (n=103) received dutasteride 0.5 mg/day, tadalafil 20 mg/day, and solifenacin 10 mg/day. The functional status of the lower urinary tract was assessed using the International Prostate Symptom Score (I-PSS), Overactive Bladder Questionnaire (OABq), International Index of Erectile Function (IIEF), and Male Sexual Health Questionnaire Ejaculatory Dysfunction (MSHQ-EjD) as well as uroflowmetry. RESULTS The total score of the sexual function remained unchanged in Group B of patients 81.3 points vs. 80.2 points (p>0.05) according to MSHQ-EjD, 61.4 points vs. 51.2 points (p>0.05) according to IIEF data. The total assessment of symptoms of hyperactivity significantly decreased in Group C according to OABq data after the 4th week of the study (17.5 points vs. 26.1 points, p<0.05) and remained below the baseline until the end of the study (15.2 points). CONCLUSIONS The simultaneous administration of standard doses of dutasteride, solifenacin, and tadalafil for 3 months is safe, effective, and can be recommended for patients with BPH to reduce symptoms of obstruction and hyperactivity of the bladder and maintain sexual function.
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Affiliation(s)
- Kirill Kosilov
- Department of Social Sciences, School of Humanities, Far Eastern Federal University, Vladivostok, Primorsky region, Russian Federation,Department of Clinical Medicine, School of Medicine, Far Eastern Federal University, Vladivostok, Primorsky region, Russian Federation,Corresponding author. Department of Social Sciences, School of Humanities, Far Eastern Federal University, Vladivostok, Primorsky region, Russian Federation.
| | - Irina Kuzina
- Department of Social Sciences, School of Humanities, Far Eastern Federal University, Vladivostok, Primorsky region, Russian Federation
| | - Vladimir Kuznetsov
- Department of Public Health, Pacific State Medical University, Vladivostok, Primorsky region, Russian Federation
| | - Olga Barabash
- Department of Physical Culture and Health and Sports Work, Vladivostok State University of Economics and Service, Vladivostok, Primorsky region, Russian Federation
| | - Ekaterina Fedorishcheva
- Department of Public Health, Pacific State Medical University, Vladivostok, Primorsky region, Russian Federation
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Agrawal M, Kumar M, Pandey S, Aggarwal A, Sankhwar S. Changing profiles of patients undergoing transurethral resection of the prostate over a decade: A single-center experience. Urol Ann 2019; 11:270-275. [PMID: 31413505 PMCID: PMC6676823 DOI: 10.4103/ua.ua_198_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Context: Patients with benign prostatic hyperplasia (BPH) usually form the bulk in urology outpatient departments. The management options include medical therapy or surgery. Transurethral resection of the prostate (TURP) has been the mainstay of surgical management. The use of medical therapy has increased over the years. This has led to a shift in the profiles of patients undergoing surgical management of BPH. Aims: We conducted this study to analyze the differences in profiles of patients undergoing TURP over a decade. Settings and Design: This was a retrospective study. Subjects and Methods: We retrospectively reviewed the medical records of all patients who underwent TURP from January 1 to December 31 in 2006 and 2016. The age, preexisting comorbidities, prostate volume, operative time, mean prostatic tissue removed, duration of hospitalization, and complications were evaluated among the two groups of patients. Charlson comorbidity index was used to evaluate the preexisting comorbidities, and the modified Clavien classification system was used for evaluating the perioperative and postoperative complications. Results: A total of 114 and 125 patients underwent TURP in 2006 and 2016, respectively. The mean age of the patients was 62.1 ± 8.22 and 66.94 ± 9.12 years in 2006 and 2016, respectively. The serum prostate-specific antigen levels increased from 4.39 ± 4.425 to 5.59 ± 7.61 ng/ml a decade apart. A number of patients taking medical therapy before surgical intervention increased from 62.23% to 75.2% (P < 0.05). There was a significant increase in the mean prostatic volume and weight. There was only a modest increase of 1.94% in the total number of complications (P > 0.05) and no significant change in the rates of complications. Conclusions: Medical therapy for BPH patients has resulted in delayed surgical interventions. The complication rates have not increased. Thus, the increased use of medical therapy in BPH patients is justified though TURP may still be considered the gold standard.
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Affiliation(s)
- Manav Agrawal
- Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Manoj Kumar
- Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Siddharth Pandey
- Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Ajay Aggarwal
- Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Satyanarayan Sankhwar
- Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India
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Kosilov K, Kuzina I, Kuznetsov V, Gainullina Y, Kosilova L, Karashchuk E, Prokofyeva A, Loparev S. The Risk of Sexual Dysfunction and Effectiveness of Treatment of Benign Prostatic Hyperplasia With Severe Lower Urinary Tract Dysfunction With Combination of Dutasteride and Solifenacin. J Sex Med 2018; 15:1579-1590. [DOI: 10.1016/j.jsxm.2018.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 09/10/2018] [Accepted: 09/17/2018] [Indexed: 11/16/2022]
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Minimally invasive prostatic urethral lift (PUL) efficacious in TURP candidates: a multicenter German evaluation after 2 years. World J Urol 2018; 37:1353-1360. [PMID: 30283994 PMCID: PMC6620255 DOI: 10.1007/s00345-018-2494-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 07/25/2018] [Indexed: 02/07/2023] Open
Abstract
Introduction Successful outcomes have been reported for the treatment of lower urinary tract symptoms (LUTS) with the prostatic urethral lift (PUL) in a number of clinical investigations. Our aim was to investigate PUL outcomes in patients treated in a day-to-day clinical setting without the rigid exclusion criteria of clinical studies. Materials and methods We investigated the outcome of the PUL procedure at five German departments during the initial period when PUL was approved for the clinic (10/2012–06/2014). All candidates for transurethral resection of the prostate (TURP) received PUL information and were given the choice of procedures. The only exclusion criterion was an obstructive median lobe. No patients were excluded because of high post-void residual volume (PVR), prostate size, retention history or LUTS oral therapy. Maximum urinary flow (Qmax), PVR, International Prostate Symptom Score (IPSS) and Quality of Life (QOL) were assessed at baseline, 1, 6, 12, and 24 months after surgery. Results Of 212 TURP candidates, 86 choose PUL. A mean of 3.8 (2–7) UroLift implants were implanted in patients of 38–85 years with a prostate size of 17–111 ml over 57 (42–90) min under general or local anesthesia. Thirty-eight (38.4%) patients had severe BPH obstruction and would have been denied PUL utilizing previously reported study criteria. Within 1 month 74 (86%) reported substantial symptom relief with significant improvements in Qmax, PVR, IPSS, and QOL (p < 0.001) that was maintained within the follow-up. Sexual function including ejaculation was unchanged or improved. No Clavien–Dindo Grad ≥ 2 was reported postoperatively. Eleven (12.8%) patients were retreated over 2 years. Twelve (86%) of 14 patients presenting with chronic urinary retention were catheter free at last follow-up. Conclusion PUL is a promising surgical technique that may alleviate LUTS, even in patients with severe obstruction.
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Davis NF, Jack GS, Witjes WP, Bjartell A, Caris C, Patel A, de la Taille A, Lawrentschuk N, Bolton DM, Tubaro A. Medical therapy versus transurethral resection of the prostate (TURP) for the treatment of symptomatic benign prostatic enlargement (BPE): a cost minimisation analysis. World J Urol 2018; 37:873-878. [PMID: 30145778 DOI: 10.1007/s00345-018-2454-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 08/14/2018] [Indexed: 12/17/2022] Open
Abstract
PURPOSE A cost minimisation analysis compares the costs of different interventions' to ascertain the least expensive over time. We compared different prostate targeted drug treatments with TURP to identify the optimal cost saving duration of a medical therapy for symptomatic benign prostatic enlargement (BPE). METHODS The Evolution registry is a prospective, multicentre registry, conducted by the European Association of Urology Research Foundation (EAUrf) for 24 months in 5 European countries. Evolution was designed to register the management of symptomatic BPE in clinical practice settings in 5 European countries. Direct cost evaluation associated with prostate targeted medical therapies and TURP was also recorded and analysed. RESULTS In total, 1838 men were enrolled with 1246 evaluable at 24 months. Medical therapies were more cost saving than TURP for treatment durations ranging from 2.9 to 70.4 years. Cost saving depended on both medication class and individual country assessed. Daily tamsulosin monotherapy was more cost saving than TURP for ≤ 13.9 years in Germany compared to ≤ 32.7 years in Italy. Daily finasteride monotherapy was more cost saving for ≤ 5.9 years in France compared to ≤ 36.9 years in Spain. Combination therapy was more cost saving for ≤ 5.9 years for Italian patients versus ≤ 13.8 years in Germany. CONCLUSIONS BPE medical management was more cost saving than TURP for different specific treatment durations. Information from this study will allow clinicians to convey medical and surgical costs over time, to both patients and payors alike, when considering BPE treatment.
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Affiliation(s)
- Niall F Davis
- Department of Urology, The Austin Hospital, Heidelberg, Melbourne, 3084, Australia.
| | - G S Jack
- Department of Urology, The Austin Hospital, Heidelberg, Melbourne, 3084, Australia
| | - W P Witjes
- EAU Research Foundation, P.O. Box 30016, 6803 AA, Arnhem, The Netherlands
| | - A Bjartell
- EAU Research Foundation, P.O. Box 30016, 6803 AA, Arnhem, The Netherlands.,Department of Urology, Lund University, Skane Hospital, Malmö, Sweden
| | - C Caris
- EAU Research Foundation, P.O. Box 30016, 6803 AA, Arnhem, The Netherlands
| | - A Patel
- Department of Urology, Spire London East Hospital, Roding Lane South, Redbridge, Essex, Ilford, IG4 5PZ, UK
| | - A de la Taille
- Department of Urology, Assistance Publique des Hopitaux de Paris, 54 av du Mal de Lattre de Tassigny, 94000, Créteil, France
| | - N Lawrentschuk
- Department of Urology, The Austin Hospital, Heidelberg, Melbourne, 3084, Australia
| | - D M Bolton
- Department of Urology, The Austin Hospital, Heidelberg, Melbourne, 3084, Australia
| | - A Tubaro
- Department of Urology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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Dimitropoulos K, Gravas S. New therapeutic strategies for the treatment of male lower urinary tract symptoms. Res Rep Urol 2016; 8:51-9. [PMID: 27218069 PMCID: PMC4853157 DOI: 10.2147/rru.s63446] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Male lower urinary tract symptoms (LUTS) are prevalent in the general population, especially in those of advanced age, and are characterized by notable diversity in etiology and presentation, and have been proven to cause various degrees of impairment on quality of life. The prostate has traditionally been regarded as the core cause of male LUTS. As a result, medical treatment aims to provide symptomatic relief and effective management of progression of male LUTS due to benign prostatic enlargement. In this context, α1-blockers, phosphodiesterase-5 inhibitors, and 5α-reductase inhibitors have long been used as monotherapies or in combination treatment to control voiding LUTS. There is accumulating evidence, however, that highlights the role of the bladder in the pathogenesis of male LUTS. Current research interests have shifted to bladder disorders, and medical management is aimed at the bladder. Muscarinic receptor antagonists and the newly approved β3-adrenergic agonist mirabegron aim to alleviate the most bothersome storage LUTS and thus improve quality of life. As voiding and storage LUTS frequently coexist, combination therapeutic strategies with α1-blockers and antimuscarinics or β3-agonists have been introduced to manage symptoms effectively. Anti-inflammatory agents, vitamin D3-receptor analogs, and cannabinoids represent treatment modalities currently under investigation for use in LUTS patients. Furthermore, luteinizing hormone-releasing hormone antagonists, transient receptor-potential channel blockers, purinergic neurotransmission antagonists, Rho-kinase inhibitors, and inhibitors of endothelin-converting enzymes could have therapeutic potential in LUTS management, but still remain in the experimental setting. This article reviews new strategies for the medical treatment of male LUTS, which are dictated by the potential role of the bladder and the risk of benign prostatic hyperplasia progression. Moreover, combination treatments and therapies currently under investigation are also presented.
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Affiliation(s)
- Konstantinos Dimitropoulos
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Stavros Gravas
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
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Zhao F, Li J, Chen Y, Tian Y, Wu C, Xie Y, Zhou Y, Wang J, Xie X, Liu H. Design, Synthesis, and Biological Evaluation of Indoline and Indole Derivatives as Potent and Selective α1A-Adrenoceptor Antagonists. J Med Chem 2016; 59:3826-39. [DOI: 10.1021/acs.jmedchem.5b02023] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Fei Zhao
- Antibiotics
Research and Re-evaluation Key Laboratory of Sichuan Province, Sichuan
Industrial Institute of Antibiotics, Chengdu University, 168 Hua Guan
Road, Chengdu 610052, People’s Republic of China
| | - Jing Li
- CAS
Key Laboratory of Receptor Research, Shanghai Institute of Materia
Medica, Chinese Academy of Sciences, 555 Zu Chong Zhi Road, Shanghai 201203, People’s Republic of China
| | - Ying Chen
- CAS
Key Laboratory of Receptor Research, Shanghai Institute of Materia
Medica, Chinese Academy of Sciences, 555 Zu Chong Zhi Road, Shanghai 201203, People’s Republic of China
| | - Yanxin Tian
- CAS
Key Laboratory of Receptor Research, Shanghai Institute of Materia
Medica, Chinese Academy of Sciences, 555 Zu Chong Zhi Road, Shanghai 201203, People’s Republic of China
| | - Chenglin Wu
- CAS
Key Laboratory of Receptor Research, Shanghai Institute of Materia
Medica, Chinese Academy of Sciences, 555 Zu Chong Zhi Road, Shanghai 201203, People’s Republic of China
| | - Yanan Xie
- CAS
Key Laboratory of Receptor Research, Shanghai Institute of Materia
Medica, Chinese Academy of Sciences, 555 Zu Chong Zhi Road, Shanghai 201203, People’s Republic of China
| | - Yu Zhou
- CAS
Key Laboratory of Receptor Research, Shanghai Institute of Materia
Medica, Chinese Academy of Sciences, 555 Zu Chong Zhi Road, Shanghai 201203, People’s Republic of China
| | - Jiang Wang
- CAS
Key Laboratory of Receptor Research, Shanghai Institute of Materia
Medica, Chinese Academy of Sciences, 555 Zu Chong Zhi Road, Shanghai 201203, People’s Republic of China
| | - Xin Xie
- CAS
Key Laboratory of Receptor Research, Shanghai Institute of Materia
Medica, Chinese Academy of Sciences, 555 Zu Chong Zhi Road, Shanghai 201203, People’s Republic of China
| | - Hong Liu
- CAS
Key Laboratory of Receptor Research, Shanghai Institute of Materia
Medica, Chinese Academy of Sciences, 555 Zu Chong Zhi Road, Shanghai 201203, People’s Republic of China
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Actualización en el tratamiento médico de los síntomas del tracto urinario inferior en el varón. Semergen 2016; 42:31-7. [DOI: 10.1016/j.semerg.2015.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 04/22/2015] [Accepted: 04/24/2015] [Indexed: 11/21/2022]
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10
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Liu Y, Zhao X, Sun X, Li Y, Wang Z, Jiang J, Han H, Shen W, Corrigan CJ, Sun Y. Expression of IL-17A, E, and F and their receptors in human prostatic cancer: Comparison with benign prostatic hyperplasia. Prostate 2015; 75:1844-56. [PMID: 26356122 DOI: 10.1002/pros.23058] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 07/16/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Benign prostatic hyperplasia (BPH) and prostate cancer (PCa) are the most common urological diseases in elderly men. Although studies suggest the cytokine family might be associated with BPH and PCa, there has been no systematic comparisons of expression of IL-17A, E, F and their receptors, infiltration of inflammatory cells, and changes in structural cells in PCa and BPH. METHODS Immunohistochemistry was employed to evaluate immunoreactivity for IL-17A, E, F and their receptors IL-17RA, IL-17BR, and IL-17CR, infiltration of inflammatory cells, and changes in structural cells including endothelial cells, fibroblasts, and smooth muscle cells in prostate tissues from subjects with PCa or BPH as well as controls. RESULTS Immunostaining showed that expression of immunoreactivity for IL-17A, IL-17RA, IL-17E, and IL-17F was significantly elevated in prostatic tissue from BPH and PCa compared with that in controls, which was accompanied by increased numbers of infiltrating inflammatory cells and CD31(+) blood vessels. Compared with BPH, PCa was characterized by reduced immunoreactivity for IL-17BR and reduced numbers of CD68(+) macrophages, fibroblasts, and smooth muscle cells, although there was a trend for these changes to correlate with disease severity in both PCa and BPH. CONCLUSION Our data are compatible with hypothesis that IL-17A acting through IL-17RA, but not IL-17CR contribute to the pathogenesis of BPH and PCa. In contrast, IL-17E interacting with the IL-17BR might have an anti-tumor effect.
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Affiliation(s)
- Yanbo Liu
- Clinical Immunology Research Centre, Beihua University, Jilin City, Jilin, China
| | - Xiaohui Zhao
- Clinical Immunology Research Centre, Beihua University, Jilin City, Jilin, China
| | - Xuemei Sun
- Clinical Immunology Research Centre, Beihua University, Jilin City, Jilin, China
| | - Yongmei Li
- Clinical Immunology Research Centre, Beihua University, Jilin City, Jilin, China
| | - Zhenjiang Wang
- Clinical Immunology Research Centre, Beihua University, Jilin City, Jilin, China
| | - Jing Jiang
- Clinical Immunology Research Centre, Beihua University, Jilin City, Jilin, China
| | - Huiming Han
- Clinical Immunology Research Centre, Beihua University, Jilin City, Jilin, China
| | - Weigao Shen
- Clinical Immunology Research Centre, Beihua University, Jilin City, Jilin, China
| | - Chris J Corrigan
- Division of Asthma, Allergy and Lung Biology, King's College London, London, UK
| | - Ying Sun
- Clinical Immunology Research Centre, Beihua University, Jilin City, Jilin, China
- Division of Asthma, Allergy and Lung Biology, King's College London, London, UK
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Andersson KE. Drug therapy of overactive bladder--what is coming next? Korean J Urol 2015; 56:673-9. [PMID: 26495067 PMCID: PMC4610893 DOI: 10.4111/kju.2015.56.10.673] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 09/03/2015] [Indexed: 01/25/2023] Open
Abstract
After the approval and introduction of mirabegron, tadalafil, and botulinum toxin A for treatment of lower urinary tract symptoms/overactive bladder, focus of interest has been on their place in therapy versus the previous gold standard, antimuscarinics. However, since these agents also have limitations there has been increasing interest in what is coming next - what is in the pipeline? Despite progress in our knowledge of different factors involved in both peripheral and central modulation of lower urinary tract dysfunction, there are few innovations in the pipe-line. Most developments concern modifications of existing principles (antimuscarinics, β3-receptor agonists, botulinum toxin A). However, there are several new and old targets/drugs of potential interest for further development, such as the purinergic and cannabinoid systems and the different members of the transient receptor potential channel family. However, even if there seems to be good rationale for further development of these principles, further exploration of their involvement in lower urinary tract function/dysfunction is necessary.
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Affiliation(s)
- Karl-Erik Andersson
- Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston Salem, NC, USA. ; Aarhus Institute for Advanced Sciences, Aarhus University, Aarhus, Denmark
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Gupta K, Yezdani M, Sotelo T, Aragon-Ching JB. A synopsis of drugs currently in preclinical and early clinical development for the treatment of benign prostatic hyperplasia. Expert Opin Investig Drugs 2015; 24:1059-73. [PMID: 25982036 DOI: 10.1517/13543784.2015.1048333] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Benign prostatic hyperplasia (BPH) is a common disease among men and significantly impacts quality of life by causing lower urinary tract symptoms (LUTS). Current medical therapies are not always adequate in controlling LUTS or slowing disease progression, and there is unmet need for new effective therapeutic options. AREAS COVERED The authors review the standard current medical therapies for BPH which include the use of α-1 blockers, 5-α reductase inhibitors, combination therapy and PDE inhibitors. Following this, the authors then discuss new therapies that are currently undergoing preclinical and clinical investigation. EXPERT OPINION Existing preclinical and clinical trials have highlighted many promising therapies to treat BPH. Further investigation with larger clinical trials is needed to establish these drugs as standard therapies. As the number of drugs in the arsenal against BPH continues to grow, providers and patients will have to engage in a discussion that weighs the risks and benefits of each therapy.
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Affiliation(s)
- Kanika Gupta
- George Washington University School of Medicine and Health Sciences, Department of Medicine , 2150 Pennsylvania Avenue NW, Washington, DC 20037 , USA
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