EVIDENCE SYNTHESIS The most studied combination therapy for the treatment of male LUTS is the α1-adrenoceptor antagonist/5α-reductase inhibitor combination .
This combination seems to be more efficacious in terms of several outcome variables , in particular in men who have moderate-to-severe LUTS and are at risk of disease progression .
Also in terms of nocturia improvements , this combination is significantly more effective than the monotherapy .
The other often studied combination treatment , in both male and female patients with LUTS , was the combination of antimuscarinics ( in particular solifenacin ) and mirabegron .
This combination seems to be more effective in comparison with the monotherapies with respect to urinary incontinence and urgency urinary incontinence episodes and several other objective and subjective parameters , without relevant increase of adverse events .
The combination of hormone therapy and antimuscarinics in women with LUTS does not seem to be useful .
For the treatment of LUTS in men and women , combination therapy appears to be a promising option to optimize the efficacy of the available drugs for those who do not experience sufficient benefit with monotherapy .
This add-on scenario offers the possibility to have a more tailored approach to the management of LUTS , always seeking the optimal balance between efficacy and tolerability for a given patient .
PATIENT SUMMARY Some combination of drugs may offer advantages over monotherapies for the treatment of voiding and storage complaints in men and women
CONTEXT Several drugs are approved and available for the treatment of lower urinary tract symptoms ( LUTS ) in men and women .
However , the vast majority of available data , upon which the approval and recommendation in guidelines are based , considered only the role of the monotherapies and did not evaluate possible combination therapies .
OBJECTIVE This systematic review analyzes the efficacy and adverse events of combination therapies for male and female LUTS .
Assessing Preference-Based Outcome Measures for Overactive Bladder: An Evaluation of Patient-Reported Outcome Data from the BESIDE Clinical Trial
Objectives The aim of this study was to compare outcomes using two preference-based measures of health status ( EQ-5D-5L and OAB-5D ) in patients with overactive bladder ( OAB ) treated with solifenacin plus mirabegron or solifenacin monotherapy in the BESIDE trial . Methods Patients with OAB who remained incontinent after 4 weeks ’ treatment with solifenacin 5 mg were r and omized 1:1:1 to combination treatment ( solifenacin 5 mg plus mirabegron [ 25 mg for the first 4 weeks/50 mg for the last 8 weeks ] ) , solifenacin 5 mg , or solifenacin 10 mg . EQ-5D-5L and OAB-q were administered at baseline , weeks 4 , 8 , 12 , and end of treatment ( EoT ) . OAB-5D scores were derived from OAB-q results . Responder analysis was carried out using several definitions of minimally important difference . Results A total of 2054 patients received one or more doses of study treatment ( combination , n = 694 ; solifenacin 5 mg , n = 684 ; solifenacin 10 mg , n = 676 ) . EQ-5D-5L Index mean score changes ( from baseline to EoT ) were greater with combination ( 0.059 ) than with solifenacin 5 mg ( 0.040 ) and 10 mg ( 0.044 ) monotherapy , but the differences were not statistically significant . A significantly greater improvement was observed for combination on OAB-5D ( 0.107 vs 0.085 for 5 mg , and 0.087 for 10 mg ; p ≤ 0.01 ) . The dimensions most improved overall were anxiety/depression , pain/discomfort , and usual activities on EQ-5D-5L , and urge , urine loss , and coping on OAB-5D . The proportion of responders was significantly greater with combination compared with monotherapy using OAB-5D only . Conclusions Improvements were observed in all study arms on both the EQ-5D-5L and OAB-5D , although only the OAB-5D showed a statistically significant benefit for combination versus solifenacin monotherapy . Combining generic and condition-specific preference-based health status measures allowed for assessment of dimensions that were particularly relevant to this patient population , while permitting comparison with outcomes from other studies , treatments , and population s via EQ-5D
EVIDENCE SYNTHESIS The most studied combination therapy for the treatment of male LUTS is the α1-adrenoceptor antagonist/5α-reductase inhibitor combination .
This combination seems to be more efficacious in terms of several outcome variables , in particular in men who have moderate-to-severe LUTS and are at risk of disease progression .
Also in terms of nocturia improvements , this combination is significantly more effective than the monotherapy .
The other often studied combination treatment , in both male and female patients with LUTS , was the combination of antimuscarinics ( in particular solifenacin ) and mirabegron .
This combination seems to be more effective in comparison with the monotherapies with respect to urinary incontinence and urgency urinary incontinence episodes and several other objective and subjective parameters , without relevant increase of adverse events .
The combination of hormone therapy and antimuscarinics in women with LUTS does not seem to be useful .
For the treatment of LUTS in men and women , combination therapy appears to be a promising option to optimize the efficacy of the available drugs for those who do not experience sufficient benefit with monotherapy .
This add-on scenario offers the possibility to have a more tailored approach to the management of LUTS , always seeking the optimal balance between efficacy and tolerability for a given patient .
PATIENT SUMMARY Some combination of drugs may offer advantages over monotherapies for the treatment of voiding and storage complaints in men and women
CONTEXT Several drugs are approved and available for the treatment of lower urinary tract symptoms ( LUTS ) in men and women .
However , the vast majority of available data , upon which the approval and recommendation in guidelines are based , considered only the role of the monotherapies and did not evaluate possible combination therapies .
OBJECTIVE This systematic review analyzes the efficacy and adverse events of combination therapies for male and female LUTS .