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Comparison of Characteristics of Benign Prostatic Hyperplasia (BPH) Patients Treated with Finasteride and Alpha Blocker Combination Therapy Versus Alpha Blocker Monotherapy in China: An Analysis of Electronic Medical Record Data

Abstract

Introduction

Benign prostatic hyperplasia (BPH) is commonly treated with 5-alpha-reductase inhibitor/alpha blocker combination therapy or with alpha blocker monotherapy. However, in China, the characteristics of BPH patients receiving 5-alpha-reductase inhibitor/alpha blocker combination therapy or alpha blocker monotherapy remain largely unknown. Therefore, this study compared the characteristics of BPH patients receiving either the 5-alpha-reductase inhibitor finasteride in combination with an alpha blocker or an alpha blocker as monotherapy in clinical practice in China.

Methods

Data were obtained from a large electronic medical record database from four tertiary hospitals in major cities in China (2009–2016). BPH patients aged ≥ 50 years with ≥ 1 alpha blocker fill on/after the first BPH diagnosis were selected. Patients were further classified as receiving combination therapy (≥ 1 overlapping day of supply for finasteride and an alpha blocker) or alpha blocker monotherapy (did not receive any 5-alpha-reductase inhibitor). Patient characteristics, visit type (in- vs. outpatient) at treatment initiation, and comorbidities were evaluated during the 6-month baseline period and compared between the two groups using two sample t tests and chi-square tests/Fisher’s exact tests.

Results

A total of 2666 and 2738 patients received combination therapy and monotherapy, respectively. The combination group was older (70.3 vs. 67.3 years, p < 0.0001) and had more patients initiated in an inpatient setting (46.0% vs. 26.4%, p < 0.0001). Compared with the monotherapy group, the combination group had more comorbidities, such as hypertension (48.3% vs. 35.6%, p < 0.0001), cardiovascular disease (65.3% vs. 48.0%, p < 0.0001), and diabetes (21.1% vs. 15.7%, p < 0.0001), and a higher Charlson comorbidity index (0.9 vs. 0.7, p < 0.0001).

Conclusion

Chinese BPH patients using finasteride/alpha blocker combination therapy were older and had a higher comorbidity burden than those using alpha blocker monotherapy. These findings provide Chinese healthcare decision-makers with a better understanding of the patient characteristics generally associated with BPH combination therapy vs. alpha blocker monotherapy.

Funding

Merck Sharp and Dohme (China) Co., Ltd., Shanghai, China.

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Acknowledgements

Funding

Sponsorship for this study and article processing charges was funded by Merck Sharp and Dohme (China) Co., Ltd., Shanghai, China. All authors had full access to all of the data in this study and take complete responsibility for the integrity of the data and accuracy of the data analysis.

Medical Writing Assistance

Medical writing assistance was provided by Cinzia Metallo, PhD, an employee of Analysis Group, Inc. Support for this assistance was funded by Merck Sharp and Dohme (China) Co., Ltd., Shanghai, China.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published.

Disclosures

Yanyan Fu is an employee of MSD China Holding Co. (Shanghai, China). Li Wang is an employee of MSD China Holding Co. (Shanghai, China). Xian Cao is an employee of MSD China Holding Co. (Shanghai, China). Simeng Han is an employee of Analysis Group Inc., which has received consultancy fees from MSD China Holding Co. (Shanghai, China). Wei Gao is an employee of Analysis Group Inc., which has received consultancy fees from MSD China Holding Co. (Shanghai, China). Eric Wu is an employee of Analysis Group Inc., which has received consultancy fees from MSD China Holding Co. (Shanghai, China). Jianye Wang has received research grants from MSD China Holding Co. (Shanghai, China) and a speaker honorarium from MSD China Holding Co. (Shanghai, China).

Compliance with Ethics Guidelines

This article does not contain any new studies with human or animal subjects performed by any of the authors.

Data Availability

The manuscript has no associated data or the data will not be deposited.

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Correspondence to Jianye Wang.

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Fu, Y., Han, S., Wang, L. et al. Comparison of Characteristics of Benign Prostatic Hyperplasia (BPH) Patients Treated with Finasteride and Alpha Blocker Combination Therapy Versus Alpha Blocker Monotherapy in China: An Analysis of Electronic Medical Record Data. Adv Ther 35, 1191–1198 (2018). https://doi.org/10.1007/s12325-018-0748-3

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Keywords

  • 5-Alpha-reductase inhibitors
  • Alpha blockers
  • Benign prostatic hyperplasia
  • China
  • Combination therapy
  • Patient characteristics
  • Urology