A randomized long-term comparative study of clinical efficacy of alpha 1-blocker with or without antiandrogen therapy for benign prostatic hyperplasia: focusing on improvement of I-PSS

• Published in: Hinyokika kiyo. Acta urologica Japonica Vol. 46; no. 11; pp. 791 - 797
• Main Authors: Ohtani, M, Kikuchi, K, Tsuchiya, A, Noguchi, R, Akaza, H, Kondo, F, Koiso, K
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.11.2000
• Subjects: Adrenergic alpha-Antagonists - therapeutic use; Aged; Aged, 80 and over; Androgen Antagonists - therapeutic use; Chlormadinone Acetate - therapeutic use; Drug Therapy, Combination; Humans; Male; Middle Aged; Prostatic Hyperplasia - drug therapy; Prostatic Hyperplasia - physiopathology; Severity of Illness Index; Sulfonamides - therapeutic use; Time Factors; Treatment Outcome; Urodynamics
• ISSN: 0018-1994

This study was conducted to examine the efficacy of administration of tamsulosin hydrochloride alone or in combination with chlormadinone acetate (CMA) against lower urinary tract symptoms for a period of 52 weeks in 33 patients with benign prostatic hyperplasia. The patients were randomly allocated into a group administered tamsulosin alone and a group administered tamsulosin in combination with CMA. Based on the assessment of the total I-PSS (International Prostate Symptom Score), significant symptomatic improvement was noted 4 weeks after the commencement of drug administration in the tamsulosin + CMA group, whereas no significant improvement was observed in the tamsulosin group. Both irritative and obstructive bladder symptoms improved significantly at any time of assessment after 4 weeks of drug administration in the tamsulosin + CMA group; however, significant improvement was noted only at week 16 and week 52 for irritative symptoms and at week 16 for obstructive symptoms in the tamsulosin group. In particular, obstructive symptoms showed significant improvement at week 4 in the tamsulosin + CMA group, as compared with that in the tamsulosin group. The average value of peak urinary flow rate was significantly increased in the tamsulosin + CMA group (10.4 ml/s to 15.6 ml/s) as compared with that in the tamsulosin group (8.5 ml/s to 10.5 ml/s). These findings indicate that combined administration of tamsulosin and CMA resulted in early improvement of lower urinary tract symptoms in these patients. Long-term combined administration of tamsulosin and CMA thus appears to be a promising treatment strategy for the improvement of obstructive symptoms and peak urinary flow rate, particularly, 16 weeks onward after administration in patients with benign prostatic hyperplasia.