Purpose: The primary aim of this study was to investigate whether initial therapy with dutasteride followed by dutasteride with as-needed tamsulosin can prevent symptom progression in patients at a high risk of clinical progression of benign prostatic hyperplasia (BPH).
Patients and Methods: This study was an open-label, single-site pilot study of 63 patients. Patients were men > 50 years of age, with a clinical diagnosis of BPH based on medical history, symptom scores, and medical exams. Each patient was prescribed 0.5 mg once daily of dutasteride for 1 year, at which time 0.4 mg once daily of tamsulosin was added. After 3 months of combination therapy, subjects were counseled to taper or discontinue tamsulosin and to restart only on an as-needed basis. Patients returned to the clinic at 6, 9, and 12 months when they were evaluated and drug compliance was measured.
Results: Adding tamsulosin to dutasteride resulted in a 41% improvement in IPSS and a 62% improvement in Qmax after 3 and 6 months, respectively, which were maintained regardless of subsequent tamsulosin use.
Conclusion: The partial or total withdrawal of tamsulosin after 1 year of 5-ARI, followed by combination therapy for 3 months, resulted in little or no deterioration of LUTS in men with BPH in the final 12 months of the study.
Paul F Siami, Knox Beasley
Submitted: October 24, 2011
Accepted for Publication: December 15, 2011
KEYWORDS: Dutasteride; Tamsulosin; Benign prostatic hyperplasia
CORRESPONDENCE: Paul F Siami, MD, 3521 Lincoln Ave, Evansville, IN 47714 USA ( ).
CITATION: UroToday Int J. 2012 Feb;5(1):art 93.
doi: http://dx.doi.org/10.3834/uij.1944-5784.2012.02.11