Practical use of Adenoprosin® in combination therapy in men with lower urinary tract symptoms

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Abstract

Aim. The aim of the observational cohort study is to study and evaluate the efficiency of the drug Adenoprosin® in combination with other drugs in comparison with monotherapy.

Materials and methods. Data from 6,442 patients at 221 medical institutions in 39 cities from November 2020 to December 2022 were analyzed. The drug Adenoprosin® in the form of rectal suppositories was prescribed as monotherapy in group I, while patients in group II received Adenoprosin® in a combination with other drugs. The efficacy of treatment was assessed using uroflowmetry data, prostate volume, postvoid residual volume and validated scales (NIH-CPSI, IIEF-5, IPSS, QoL).

Results. The diagnosis was validated in 6375 cases, including BPH (n=1498), chronic prostatitis (CP; n=3060), and in combination of both disorders (n=1817). A total of 3580 patients received Adenoprosin® as monotherapy, while 2761 received combination therapy. In most cases, a combination therapy was prescribed in case of more severe disease. In patients with BPH, positive changes after treatment were noted in favor of group I according to change in postvoid residual volume (p<0.001) and prostate volume (p<0.001). Combination therapy demonstrated significant positive changes compared with monotherapy when assessing NIH-CPSI scores (p=0.005), IPSS scores (p<0.001) and the mean maximum urine flow rate (Qmax; p<0.001). Qmax increased significantly in both groups (from 14 ml/s to 17 ml/s in group I and from 12 ml/s to 14 ml/s in group II).

Conclusion. Treatment of BPH, CP and their combination is a complex clinical task. The multiple nature of complaints often dictates the need for simultaneous administration of two or more drugs. Combination therapy involves the use of multiple therapeutic strategies to treat different aspects of BPH and CP.

In patients with BPH, a combination therapy has been shown to be more effective than monotherapy with either class of drugs, as it reduces the risk of disease progression, acute urinary retention, and the need for surgery. However, combination therapy should be considered on an individual basis, taking into account symptoms, prostate size and overall health. There is no universal treatment method for BPH suitable for any patient. The treatment strategy should be chosen individually, considering all medical and social factors.

All of the above applies to a large extent to the treatment of CP and CP + BPH. According to our results, Adenoprosin® demonstrated efficacy both as monotherapy and in combination with other traditional drugs in the treatment of men with lower urinary tract symptoms.

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About the authors

G. R. Kasyan

FGBOU VO “Russian University of Medicine”; Moscow Urologic Center, S.P. Botkin’s State Clinical Hospital

Author for correspondence.
Email: g.kasyan@outlook.com

Ph.D., MD, professor at the Department of Urology of FGBOU VO “Russian University of Medicine”, Head of the Urologic Department of S.P. Botkin’s State Clinical Hospital

Russian Federation, Moscow; Moscow

L. A. Khodyreva

Moscow Urologic Center, S.P. Botkin’s State Clinical Hospital

Email: g.kasyan@outlook.com

Ph.D., MD, Moscow Urologic Center, S.P. Botkin’s State Clinical Hospital

Russian Federation, Moscow

B. L. Grigoryan

FGBOU VO “Russian University of Medicine”

Email: g.kasyan@outlook.com

Department of Urology of FGBOU VO “Russian University of Medicine”

Russian Federation, Moscow

V. V. Dyakov

FGBOU VO “Russian University of Medicine”; Moscow Urologic Center, S.P. Botkin’s State Clinical Hospital

Email: g.kasyan@outlook.com

Department of Urology of FGBOU VO “Russian University of Medicine”, Moscow, Russia; Moscow Urologic Center, S.P. Botkin’s State Clinical Hospital

Russian Federation, Moscow; Moscow

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Supplementary files

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2. Fig. 1. Dynamics of clinical manifestations according to NIH-CPSI scale in patients with BPH: a - monotherapy group, b - combination therapy group

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3. Fig. 2. Dynamics of prostate volume in patients with BPH: a - monotherapy group, b - combination therapy group

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4. Fig. 3. Dynamics of maximum volumetric urine flow velocity in patients with BPH: a - monotherapy group, b - combination therapy group

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5. Fig. 4. Dynamics of clinical manifestations according to NIH-CPSI scale in patients with CP: a - monotherapy group, b - combination therapy group

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6. Fig. 5. Dynamics of maximal volumetric urine flow velocity in patients with CP and BPH: a - monotherapy group, b - combination therapy group

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7. Fig. 6. Dynamics of prostate gland volume in patients with CP and BPH: a - monotherapy group, b - combination therapy group

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8. Fig. 7. Dynamics of clinical manifestations according to MIEF-5 scale in patients with CP and BPH: a - monotherapy group, b - combination therapy group

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9. Fig. 8. Dynamics of clinical manifestations according to NIH-CPSI scale in patients with CP and BPH: a - monotherapy group, b - combination therapy group

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