Skip to main content

Advertisement

Log in

Efficacy and safety of a combination of Sabal and Urtica extract in lower urinary tract symptoms—long-term follow-up of a placebo-controlled, double-blind, multicenter trial

  • Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

In an open-label extension of a randomized, double-blind clinical trial, the long-term efficacy and tolerability of a fixed combination of 160 mg Sabal fruit extract WS 1473 and 120 mg Urtica root extract WS 1031 per capsule (PRO 160/120) were investigated in elderly men with moderate or severe lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH). Two hundred and fifty-seven patients were randomly treated with 2 × 1 capsule/day PRO 160/120 or placebo for 24 weeks, followed by a 24-week control period and a 48-week follow-up period in which all patients received PRO 160/120. Efficacy measures included the assessment of LUTS [International Prostate Symptom Score ((I-PSS) self-rating questionnaire] and uroflow and sonographic parameters. Two hundred and nineteen subjects participated in the follow-up. Between baseline and end of observation (week 96) the I-PSS total score was reduced by 53% (P < 0.001), peak and average urinary flow increased by 19% (P < 0.001), and residual urine volume decreased by 44% (P = 0.03). The incidence of adverse events during follow-up was one in 1,181 treatment days; in only one event a causal relationship with intake of PRO 160/120 could not be excluded. Treatment with PRO 160/120 thus provides a clinically relevant benefit over a period of 96 weeks.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Notes

  1. Marketed in Germany under the trade name Prostagutt forte, Dr. Willmar Schwabe, Karlsruhe, Germany.

  2. WS 1473 and WS 1031 are registered trademarks of Dr. Willmar Schwabe GmbH & Co. KG.

References

  1. Verhamme KM, Dieleman JP, Bleumink GS, van der Lei J, Sturkenboom MC, Artibani W et al (2002) Incidence and prevalence of lower urinary tract symptoms suggestive of benign prostatic hyperplasia in primary care—the Triumph project. Eur Urol 42:323–328

    Article  PubMed  CAS  Google Scholar 

  2. Gades NM, Jacobson DJ, Girman CJ, Roberts RO, Lieber MM, Jacobsen SJ (2005) Prevalence of conditions potentially associated with lower urinary tract symptoms in men. BJU Int 95:549–553

    Article  PubMed  Google Scholar 

  3. Clifford GM, Farmer RD (2000) Medical therapy for benign prostatic hyperplasia: a review of the literature. Eur Urol 38:2–19

    Article  PubMed  CAS  Google Scholar 

  4. Lowe FC, Fagelman E (2002) Phytotherapy in the treatment of benign prostatic hyperplasia. Curr Opin Urol 12:15–18

    Article  PubMed  Google Scholar 

  5. Boyle P, Robertson C, Lowe F, Roehrborn C (2004) Updated meta-analysis of clinical trials of Serenoa repens extract in the treatment of symptomatic benign prostatic hyperplasia. BJU Int 93:751–756

    Article  PubMed  CAS  Google Scholar 

  6. Gerber GS, Fitzpatrick JM (2004) The role of a lipido-sterolic extract of Serenoa repens in the management of lower urinary tract symptoms associated with benign prostatic hyperplasia. BJU Int 94:338–344

    Article  PubMed  Google Scholar 

  7. Gong EM, Gerber GS (2004) Saw palmetto and benign prostatic hyperplasia. Am J Chin Med 32:331–338

    Article  PubMed  CAS  Google Scholar 

  8. Wilt T, Ishani A, Mac Donald R (2002) Serenoa repens for benign prostatic hyperplasia. Cochrane Database Syst Rev CD001423

  9. Dathe G, Schmid H (1987) Phytotherapie der benignen Prostatahyperplasie (BPH). Doppelblindstudie mit Extractum Radicis urticae (ERU). Urologe B 27:223–226

    Google Scholar 

  10. Vontobel HP, Herzog R, Rutishauser G, Kres H (1985) Ergebnisse einer Doppelblindstudie über die Wirksamkeit von ERU-Kapseln in der konservativen Behandlung der benignen Prostatahyperplasie. Urologe A 24:49–51

    PubMed  CAS  Google Scholar 

  11. Schneider T, Rübben H (2004) Brennnesseltrockenextrakt (Bazoton-uno) in der Langzeittherapie des benignen Prostatasyndroms (BPS). Ergebnisse einer randomisierten, doppelblinden, placebokontrollierten Multicenterstudie über 12 Monate. Urologe A 43:302–306

    Article  PubMed  CAS  Google Scholar 

  12. Goldmann WH, Sharma AL, Currier SJ, Johnston PD, Rana A, Sharma CP (2001) Saw palmetto berry extract inhibits cell growth and Cox-2 expression in prostatic cancer cells. Cell Biol Int 25:1117–1124

    Article  PubMed  CAS  Google Scholar 

  13. Koch E (2001) Extracts from fruits of saw palmetto (Sabal serrulata) and roots of stinging nettle (Urtica dioica): viable alternatives in the medical treatment of benign prostatic hyperplasia and associated lower urinary tracts symptoms. Planta Med 67:489–500

    Article  PubMed  CAS  Google Scholar 

  14. Marks LS, Hess DL, Dorey FJ, Luz Macairan M, Cruz Santos PB, Tyler VE (2001) Tissue effects of saw palmetto and finasteride: use of biopsy cores for in situ quantification of prostatic androgens. Urology 57:999–1005

    Article  PubMed  CAS  Google Scholar 

  15. Hirano T, Homma M, Oka K (1994) Effects of stinging nettle root extracts and their steroidal components on the Na+,K(+)-ATPase of the benign prostatic hyperplasia. Planta Med 60:30–33

    Article  PubMed  CAS  Google Scholar 

  16. Lichius JJ, Lenz C, Lindemann P, Müller HH, Aumüller G, Konrad L (1999) Antiproliferative effect of a polysaccharide fraction of a 20% methanolic extract of stinging nettle roots upon epithelial cells of the human prostate (LNCaP). Pharmazie 54:768–771

    PubMed  CAS  Google Scholar 

  17. Mitropoulos D, Kyroudi A, Zervas A, Papadoukakis S, Giannopoulos A, Kittas C et al (2002) In vivo effect of the lipido-sterolic extract of Serenoa repens (Permixon) on mast cell accumulation and glandular epithelium trophism in the rat prostate. World J Urol 19:457–461

    PubMed  CAS  Google Scholar 

  18. Talpur N, Echard B, Bagchi D, Bagchi M, Preuss HG (2003) Comparison of Saw Palmetto (extract and whole berry) and Cernitin on prostate growth in rats. Mol Cell Biochem 250:21–26

    Article  PubMed  CAS  Google Scholar 

  19. Wadsworth TL, Carroll JM, Mallinson RA, Roberts CT Jr, Roselli CE (2004) Saw palmetto extract suppresses insulin-like growth factor-I signaling and induces stress-activated protein kinase/c-Jun N-terminal kinase phosphorylation in human prostate epithelial cells. Endocrinology 145:3205–3214

    Article  PubMed  CAS  Google Scholar 

  20. Metzker H, Kieser M, Hölscher U (1996) Wirksamkeit eines Sabal-Urtica-Kombinationspräparats bei der Behandlung der benignen Prostatahyperplasie (BPH). Urologe B 36:292–300

    Article  Google Scholar 

  21. Sökeland J, Albrecht J (1997) Kombination aus Sabal- und Urticaextrakt vs Finasterid bei BPH. (Stad. I bis II nach Alken)—Vergleich der therapeutischen Wirksamkeit in einer einjährigen Doppelblindstudie. Urologe A 36:327–333

    Article  PubMed  Google Scholar 

  22. Sökeland J (2000) Combined sabal and urtica extract compared with finasteride in men with benign prostatic hyperplasia: analysis of prostate volume and therapeutic outcome. BJU Int 86:439–442

    Article  PubMed  Google Scholar 

  23. Barry MJ, Fowler FJ Jr, O’Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK et al (1992) The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol 148:1549–1557; discussion 1564

    Google Scholar 

  24. Engelmann U, Bondarenko B, Walther C, Funk P, Schläfke S (2006) Efficacy and safety of a combination of sabal and urtica extract in lower urinary tract symptoms. Arzneimittelforschung 56:222–229

    PubMed  CAS  Google Scholar 

  25. Lopatkin N, Sivkov A, Walther C, Schläfke S, Medvedev A, Avdeichuk J et al (2005) Long-term efficacy and safety of a combination of sabal and urtica extract for lower urinary tract symptoms—a placebo-controlled, double-blind, multicenter trial. World J Urol 23:139–146

    Article  PubMed  CAS  Google Scholar 

  26. Roehrborn CG, Abbou CC, Akaza H, Allona-Almagro A, Boccon-Gibod L, Ekman PE et al (2001) Clinical research criteria for studies of: lower urinary tract symptoms (LUTS), enlarged prostate gland (EPG), bladder outlet obstruction (BOO) and benign prostatic hyperplasia (BPH). In: Chatelain C, Denis L, Foo KT, Khoury S, Mc Connell J (eds) Benign prostatic hyperplasia. 5th International Consultation on Benign Prostatic Hyperplasia (BPH), Paris, 25–28 June 2000. Health Publication Ltd, Plymouth, pp 317–395

    Google Scholar 

  27. Pytel YA, Vinarov A, Lopatkin N, Sivkov A, Gorilovsky L, Raynaud JP (2002) Long-term clinical and biologic effects of the lipidosterolic extract of Serenoa repens in patients with symptomatic benign prostatic hyperplasia. Adv Ther 19: 297–306

    PubMed  CAS  Google Scholar 

  28. Marberger MJ (1998) Long-term effects of finasteride in patients with benign prostatic hyperplasia: a double-blind, placebo-controlled, multicenter study. PROWESS Study Group. Urology 51:677–686

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The study was funded by Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe, Germany, manufacturer of PRO 160/120.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Andrey Sivkov.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lopatkin, N., Sivkov, A., Schläfke, S. et al. Efficacy and safety of a combination of Sabal and Urtica extract in lower urinary tract symptoms—long-term follow-up of a placebo-controlled, double-blind, multicenter trial. Int Urol Nephrol 39, 1137–1146 (2007). https://doi.org/10.1007/s11255-006-9173-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-006-9173-7

Keywords

Navigation