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 .
Effects of initial combined tamsulosin and solifenacin therapy for overactive bladder and bladder outlet obstruction secondary to benign prostatic hyperplasia: a prospective, randomized, multicenter study
Purpose The purpose of the study is to evaluate the clinical efficacy of initial combined therapy of an alpha-blocker and anticholinergic agent compared with the alpha-blocker alone in patients with benign prostatic hyperplasia ( BPH ) with overactive bladder ( OAB ) . Methods Hundred and fifty-six BPH patients with International Prostate Symptom Score ( IPSS ) of over 14 ( voiding sub-score ≥8 and storage sub-score ≥6 ) were prospect ively included in Korea . Group 1 ( n = 69 ) was the patients who were treated with Tamsulosin 0.2 mg daily alone for 4 weeks and after 8 weeks they were treated with tamsulosin 0.2 mg and solifenacin 5.0 mg daily combination . Group 2 ( n = 70 ) was the patients who were treated initially with tamsulosin 0.2 mg and solifenacin 5.0 mg combination for 12 weeks . Detailed question naires were used to assess treatment satisfaction at 4th week and at 12th week of treatment in 2 groups . Results Baseline characteristics were not different between the 2 groups . In the 4th week , there was no difference between the 2 groups with regard to IPSS total score and voiding symptom score , although the IPSS storage symptom score was significantly lower in the Group 2 [ −2.0 ( 0.2 ) △ 23.8 vs. −3.0 ( 0.2 ) △ 35.7 ] ( P < 0.001 ) . In the 12th week , there was improvement in storage indices such as IPSS storage symptom score , OABSS , and urgency symptoms compared with baseline in each group ( P < 0.001 ) . No statistical differences in storage indices observed between the two groups at 12 week . Conclusions Earlier treatment with alpha-blocker and anticholinergic agent helped to improve storage symptoms and quality -of-life scores earlier for patients with lower urinary tract symptoms related to BPH and OAB symptoms
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 .