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 .
Treatment satisfaction and clinically meaningful symptom improvement in men with lower urinary tract symptoms and prostatic enlargement secondary to benign prostatic hyperplasia: Secondary results from a 6-month, randomized, double-blind study comparing finasteride plus tadalafil with finasteride pl
OBJECTIVES To report the secondary analyses of treatment satisfaction and clinical ly meaningful improvements in a r and omized study comparing coadministration of tadalafil 5 mg with finasteride 5 mg versus finasteride alone in men with prostatic enlargement secondary to benign prostatic hyperplasia . METHODS An international , r and omized , double-blind , parallel study was carried out in men aged ≥45 years who were 5-alpha reductase inhibitor naïve , and had an International Prostate Symptom Score ≥13 and prostate volume ≥30 mL ; 350 men received placebo/finasteride and 345 received tadalafil/finasteride over 26 weeks . Treatment satisfaction was assessed per protocol using the Treatment Satisfaction Scale-Benign Prostatic Hyperplasia . Responder cut-offs , analyzed post-hoc were total International Prostate Symptom Score improvement ≥3 points or ≥25 % from r and omization . RESULTS Baseline patient characteristics were generally comparable between responders and non-responders . The proportion of patients with an International Prostate Symptom Score improvement ≥3 points with tadalafil/finasteride and placebo/finasteride , respectively , at week 4 was 57.0 % and 47.9 % ( OR 1.45 , 95 % confidence interval 1.07 - 1.97 ) , at week 12 was 68.8 % and 60.7 % ( OR 1.48 , 95 % confidence interval 1.07 - 2.05 ) and at week 26 was 71.4 % and 70.2 % ( OR 1.14 , 95 % confidence interval 0.81 - 1.61 ) ; for IPSS change ≥25 % , the corresponding proportions were 44.8 % and 32.9 % ( OR 1.66 , 95 % confidence interval 1.21 - 2.28 ) , 55.5 % and 51.9 % ( OR 1.18 , 95 % confidence interval 0.87 - 1.62 ) , and 62.0 % and 58.3 % ( OR 1.23 , 95 % confidence interval 0.89 - 1.70 ) . Treatment satisfaction at week 26 was significantly greater with tadalafil/finasteride versus placebo/finasteride  for total treatment satisfaction scale score ( P=0.031 ) and satisfaction with efficacy subscore ( P = 0.025 ) ; scores were not significantly different between treatments for satisfaction with dosing or side-effects ( both P ≥ 0.371 ) . CONCLUSIONS Tadalafil/finasteride results in significantly more patients achieving early clinical meaningful improvements in symptoms , and in greater treatment satisfaction versus placebo/finasteride
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 .