Combination of a1-blockers and phosphodiesterase type 5 inhibitor in patients with benign prostatic hyperplasia and erectile dysfunction: results of observatory prospective multicenter study


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Aim. To evaluate the efficacy and safety of combination therapy with a1-blocker and phosphodiesterase type 5 inhibitor (PDE5) in patients with benign prostatic hyperplasia (BPH) and erectile dysfunction (ED). Materials and methods. The observational multicenter program involving 18 medical institutions in Moscow included 315 men aged 40-65 years with BPH and ED. The inclusion criteria were a total IPSS score more than 8 points, QoL score of more than 3 points and clinical manifestations of ED (< 20 points on the IIEF-5 score). All patients received combined pharmacotherapy with Alfuprost® MP 10 mg/day and Viatail® 50 mg/day (if necessary, the dose was increased to 100 mg/day) for 3 months. Results. The combination therapy showed a high clinical efficiency and a favorable safety profile. Lower urinary tract symptoms improved by more than 60%, QoL increased by 64% and erectile function improved in more than 80% of patients. At the end of treatment, the average patient satisfaction score on the Likert scale was 4.2 (high and very high satisfaction), while doctor’s satisfaction with the clinical response of patients to the treatment was 4.35 points, which also corresponds to high and very high efficacy of therapy. Conclusion. Combination of Alfuprost® MP 10 mg/day and Viatail® 50 mg/day (100 mg, if necessary) can be considered as one of the best options for non-surgical treatment of patients with BPH and ED.

Full Text

Restricted Access

About the authors

V. V Borisov

FGAOU VO I.M. Sechenov First Moscow State Medical University

Email: vvb56@yandex.ru
MD, professor Moscow, Russia

References

  1. Кусаинов А.М., Булегенов Т.А. Медико-социальные аспекты доброкачественной гиперплазии предстательной железы. Обзор литературы. Наука и здравоохранение. 2019;3 (21):30-44
  2. Robert F Donnell. Benign Prostate Hyperplasia: A Review of the Year’s Progress From Bench to Clinic. Curr Opin Urol. 2011;21(1):22-26. doi: 10.1097/mou.0b013e32834100dd.
  3. Nasu K., Moriyama N., Fukasawa R., Tsujimoto G., Tanaka T., Yano J., Kawabe K. Quantification and distribution of ai-adrenoceptor subtype mRNAs in human proximal urethra. British Journal of Pharmacology. 1998;123(7):1289-1293. doi: 10.1038/sj.bjp.0701731.
  4. Калинина С.Н., Кореньков Д.Г., Фесенко В.Н. Диагностика и лечение эректильной дисфункции у больных доброкачественной гиперплазией предстательной железы. Специальный выпуск: Материалы 3-й научнопрактической конференции урологов Северо-Западного федерального округа РФ: 20-21 апреля 2017 г., Санкт-Петербург. Урологические ведомости. 2017;7:43-44
  5. Marberger M., Harkaway R., de la Rosette J. Optimising the Medical Management of Benign Prostatic Hyperplasia. Eur Urol. 2004;45(4):411- 419. doi: 10.1016/j.eururo.2003.10.016.
  6. Hatano A., Takahashi H., Tamaki M., Komeyama T., Koizumi T., Takeda M. Pharmacological evidence of distinct alpha1-adrenoceptor subtypes mediating the contraction of human prostatic urethra and peripheral artery. Br J Pharmacol. 1994;113:723-728. https://doi.oig/10.1111/j. 1476-5381.1994. tb17053.x
  7. Lepor H. Medical treatment of benign prostatic hyperplasia. Rev Urol. 2011;13(1):20-33. doi: 10.3909/riu0519.
  8. Schwinn D.A., Michelotti G.A. 1-Adrenergic receptors in the lower urinary tract and vascular bed: potential role for the a1d subtype in filling symptoms and effects of aging on vascular expression. BJU Int. 2000;85:6-11. https://doi. org/10.1046/j.1464-410X.2000.00061.x
  9. Yoo T.K., Cho H.J. Benign prostatic hyperplasia: from benchto clinic. Korean J. Urol. 2012.53 139-148. https://doi.org/10.4111/kiu.2012.53.3.139
  10. JinQiu Yuan, Yali Liu, ZuYao Yang, Xiwen Qin, KeHu Yang, Chen Mao. The Efficacy and Safety of alpha-1 Blockers for Benign Prostatic Hyperplasia: An Overview of 15 Systematic Reviews Curr Med Res Opin. 2013;29(3):279-287. https://doi.org/10.1185/03007995.2013.766594
  11. Descazeaud A., de La Taille A, Giuliano F., Desgrandchamps F., Doridot G. Effetsnegatfssur la sexualite des traitementsmedicamenteux des symptomes du bas appareilurinaireliesal’hypertrophiebenigne de la prostate. Prog Urol. 2015;25(3):115-127. https://doi.org/10.1016/j.purol.2014.12.003
  12. Alison M. Mondul, Eric B. Rimm, Edward Giovannucci, Dale B. Glasser, Elizabeth A. Platz. A Prospective Study of Lower Urinary Tract Symptoms and Erectile Dysfunction. J Urol. 2008; 179(6):2321-2326. Doi:10.1016/j. juro.2008.01.150.
  13. Anton Ponholzer, Christian Temml, Rudolf Obermayr, Stephan Madersbacher. Association Between Lower Urinary Tract Symptoms and Erectile Dysfunction. Urology. 2004;64(4):772-776. doi: 10.1016/j.urology.2004.05.025.
  14. Feldman Н.А., Goldstein I., Hatzichristou D.G., Krane R.J., McKinlay J.B. Impotence and Its Medical and Psychosocial Correlates: Results of the Massachusetts Male Aging Study. J Urol. 1994;151(1):54-61. Doi:10.1016/ s0022-5347(17)34871-1.
  15. Oelke M., Giuliano F., Mirone V., Xu L., Cox D., Viktrup L. Monotherapy with Tadalafil or Tamsulosin Similarly Improved Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia in an International, Randomised, Parallel, Placebo-Controlled Clinical Trial. European Urology. 2012;61(5):917-925. doi: 10.1016/j.eururo.2012.01.013
  16. Park H.J., Park N.C. Combination therapy with dutasteride and tadalafil in men with moderete-to-severe benign prostatic hyperplasia. Eur. Urol Suppl. 2013; 12: e1092.
  17. Данилов В.В., Борисов В.В., Данилов В.В. Нейроурологические основы консервативной терапии расстройств мочеиспускания у больных аденомой предстательной железы. Владивосток, 2014
  18. Djavan B. Lower urinary tract symptoms/benign prostatic hyperplasia: fast control of the patient’s quality of life. Urology. 2003;62(3 Suppl 1):6-14. https://doi.org/10.1016/s0090-4295(03)00589-2
  19. Пушкарь Д.Ю., Раснер П.И. Терапия a-адреноблокаторами у больных ДГПЖ. Лечащий врач. 2007;4 http://www.lvrach.ru/2007/04/4535063/
  20. Eckert R.E. et al. Prostate selectivity of alpha1-adrenoceptors blockers. J. Urol. 1999;161(Suppl):163.

Supplementary files

Supplementary Files
Action
1. JATS XML

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies