This combination seems to be more efficacious in terms of several outcome variables in patients whose prostate volume is between 30 ml and 40 ml when treatment is maintained for > 1 yr ; when given for < 1 yr , α1-blockers alone are just as effective .
The combination of α1-blocker/5-ARI shows a slightly increased rate of adverse events .
It remains unknown whether its safety and superiority over either drug as monotherapy are sustained after > 6 yr .
The α1-blocker/muscarinic receptor antagonist ( antimuscarinic ) combination was most frequently assessed as an add-on therapy to already existing α1-blocker therapy .
Inconsistent data derive from heterogeneous study population s and different study design s. Currently , the α1-blocker/antimuscarinic combination appears to be a second-line add-on for patients with insufficient symptom relief after monotherapy .
The combination seems to be safe in men with postvoid residual < 200 ml .
The α1-blocker/phosphodiesterase type 5 inhibitor combination is a new treatment option with only preliminary reports .
CONCLUSIONS An α1-blocker/5-ARI combination is beneficial for patients whose prostate volume is between 30 ml and 40 ml when medical treatment is intended for > 1 yr .
Based on short-term follow-up studies , add-on of antimuscarinics to α1-blockers is an option when postvoid residual is < 200 ml
BACKGROUND Several drugs are approved for the treatment of lower urinary tract symptoms ( LUTS ) in men , but these are mostly used by clinicians as monotherapies .
The combination of different compounds , each of which targets a different aspect of LUTS , seems appealing .
However , only few clinical trials have evaluated the effects of combination therapies .
OBJECTIVE This systematic review analyzes the efficacy and adverse events of combination therapies for male LUTS .
Comparative Study of Therapeutic Effect of Dibenyline, Finasteride, and Combination Drugs for Symptomatic Benign Prostatic Hyperplasia
Objectives : A prospect i ve study was conducted in a community hospital in order to evaluate the therapeutic effect of dibenyline , finasteride , and a combination of the two drugs for symptomatic benign prostatic hyperplasia ( BPH ) . Methods : 190 men suffering from severe prostatism entered this study . They were assessed by IPSS symptom score , digital rectal examination , transrectal sonography of the prostate , uroflowmetry and residual urine . The patients were r and omly selected for medical treatment with dibenyline 10 mg b.i.d . ( n = 71 ) , finasteride 5 mg q.d . ( n = 54 ) , and a combination ( n = 65 ) . Clinical assessment s were carried out before treatment and 3 and 6 months after starting treatment . Patients who could not complete the treatment and those with prostatic cancer were excluded from the final statistics . The quality of life after 6 months of treatment and side effects were also assessed . Results : A total of 172 patients completed the treatment course and 153 patients completed the periodic clinical assessment s. Improvement in IPSS was noted in all 3 groups of patients both at 3 and 6 months . The prostatic volume was found to decrease in the finasteride group and the combination group at 6 months by 24.3 and 10.5 % , respectively . Maximal flow rate ( Qmax ) was significantly improved in the dibenyline and combination groups but not in the finasteride group at 3 months . At 6 months a significant increase in Qmax was noted in all groups with a mean increase of 1.4–1.8 ml/s . The quality of life after treatment was satisfactory in 71.9 % of the dibenyline group , 70.4 % of the finasteride group and 83.1 % of the combination group . Side effects were higher in the dibenyline than the finasteride or combination group . The dropout rate was higher in the dibenyline group ( 15.5 % ) than in the finasteride ( 7.5 % ) and combination ( 4.6 % ) groups . After 6 months of treatment , some of the patients discontinued medication and symptom relapse was noted in 92.6 % of the dibenyline group , 57.6 % of the finasteride group , and 71 % of the combination group . Conclusions : Medical treatment is effective in treating symptomatic BPH . Combination dibenyline and finasteride provides a weak synergistic clinical effect without additive side effects
This combination seems to be more efficacious in terms of several outcome variables in patients whose prostate volume is between 30 ml and 40 ml when treatment is maintained for > 1 yr ; when given for < 1 yr , α1-blockers alone are just as effective .
The combination of α1-blocker/5-ARI shows a slightly increased rate of adverse events .
It remains unknown whether its safety and superiority over either drug as monotherapy are sustained after > 6 yr .
The α1-blocker/muscarinic receptor antagonist ( antimuscarinic ) combination was most frequently assessed as an add-on therapy to already existing α1-blocker therapy .
Inconsistent data derive from heterogeneous study population s and different study design s. Currently , the α1-blocker/antimuscarinic combination appears to be a second-line add-on for patients with insufficient symptom relief after monotherapy .
The combination seems to be safe in men with postvoid residual < 200 ml .
The α1-blocker/phosphodiesterase type 5 inhibitor combination is a new treatment option with only preliminary reports .
CONCLUSIONS An α1-blocker/5-ARI combination is beneficial for patients whose prostate volume is between 30 ml and 40 ml when medical treatment is intended for > 1 yr .
Based on short-term follow-up studies , add-on of antimuscarinics to α1-blockers is an option when postvoid residual is < 200 ml
BACKGROUND Several drugs are approved for the treatment of lower urinary tract symptoms ( LUTS ) in men , but these are mostly used by clinicians as monotherapies .
The combination of different compounds , each of which targets a different aspect of LUTS , seems appealing .
However , only few clinical trials have evaluated the effects of combination therapies .
OBJECTIVE This systematic review analyzes the efficacy and adverse events of combination therapies for male LUTS .