Abstract
Purpose
To assess adherence to combination therapy comprising α-adrenergic blocker (AB) and 5α-reductase inhibitor (5ARI) for benign prostatic hyperplasia (BPH) in a real-world setting and whether lower urinary tract symptoms (LUTS) will relapse after discontinuing one medication from long-term combination therapy.
Methods
BPH/LUTS patients receiving initial AB +5ARI combination therapy for at least 1 year between January 2012 and January 2017 were retrospectively analyzed. The patients were classified into DC-AB group (n = 65, AB discontinued) and DC-5ARI group (n = 77, 5ARI discontinued) and followed up. Clinical effects were assessed at baseline and annually using the International Prostatic Symptoms Score (IPSS), quality of life (QoL) index, total prostate volume (TPV), maximal flow rate (Qmax), and prostate-specific antigen (PSA) level.
Results
Of total 1783 patients, 809 (45.4%) patients were identified with more than 1-year combination therapy. After withdrawal of one medication from combination therapy, the TPV progression (27.6% vs. − 10.8%; P < 0.001) and the requirement for prostate surgery (14.3% vs. 6.1%; P = 0.038) were significantly higher in the DC-5ARI group than in the DC-AB group. The rate of resuming combination therapy was significantly higher in the DC-5ARI group than in the DC-AB group (38.9% vs. 23.0%; P = 0.009).
Conclusions
Adherence to combination BPH therapy is relatively low. Although patients adhered to combination therapy for more than 1 year, a higher risk of requiring prostate surgery or resuming combination therapy was observed in patients who discontinued 5ARI.
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Data availability
The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.
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We thank Hye Young Han from Nowon Eulji University Hospital Library for manuscript’s technical editing.
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JDC: conceptualized the study. JDC: designed the study. TKY, JYK and HDJ: collected the original data. JHL: performed the statistical analysis of the data. JDC and JHL: performed the writing of the article.
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This study was approved by Nowon Eulji University Hospital, Eulji University School of Medicine Ethical Committee, seoul, South Korea (EMC-2021-05-021). The procedures used in this study adhere to the tenets of the Declaration of Helsinki.
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Choi, J.D., Yoo, T.K., Kang, J.Y. et al. Clinical outcomes of withdrawing one medication from long-term combination therapy comprising α-blocker and 5α-reductase inhibitor for benign prostatic hyperplasia. Int Urol Nephrol 55, 845–851 (2023). https://doi.org/10.1007/s11255-023-03476-6
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DOI: https://doi.org/10.1007/s11255-023-03476-6