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 .
Clinical efficacy and safety of imidafenacin as add-on treatment for persistent overactive bladder symptoms despite α-blocker treatment in patients with BPH: the ADDITION study.
OBJECTIVE To evaluate the effects of add-on treatment with an anticholinergic ( imidafenacin ) on persistent overactive bladder ( OAB ) symptoms despite α-blocker ( tamsulosin ) treatment in patients with benign prostatic hyperplasia ( BPH ) . METHODS Patients with BPH ≥50 years old , with urinary urgency at least once per week and total OAB symptom score ( OABSS ) ≥3 points after ≥8-week treatment with tamsulosin were enrolled in a multicenter , open-label study ( not double-blinded ) . Patients were r and omized to receive tamsulosin ( 0.2 mg/day ) alone or tamsulosin ( 0.2 mg/day ) + imidafenacin ( 0.1 mg 2 times a day ) . Primary endpoint was 12-week change in OABSS ; secondary endpoints were changes in OABSS , International Prostate Symptom Score ( IPSS ) , micturition time chart ( MTC ) , hours of undisturbed sleep ( HUS ) , and quality of life ( IPSS-QOL and BPH impact index [ BII ] ) . For statistical analysis , a mixed-effects model and t test were used . RESULTS In total , 308 men were enrolled . The change from baseline to 12 weeks in total OABSS was significantly greater with add-on imidafenacin than tamsulosin alone ( 2.11 , 95 % confidence interval [ CI ] 1.47 - 2.74 , P < .0001 ) . Improvements in frequencies of daytime urination , nighttime urination , urinary urgency , urgency incontinence , IPSS , HUS , IPSS-QOL , and BII , were significantly greater from 4 weeks through 12 weeks in the imidafenacin group . Between-group difference in postvoid residual volume at 12 weeks was not significant ( -1.74 mL , 95 % CI -8.19 to 4.72 ) , and no events of urinary retention were reported . CONCLUSION Combined tamsulosin and imidafenacin treatment is effective and safe in patients with BPH with persistent OAB symptoms  after tamsulosin monotherapy . Furthermore the combination treatment improved the QOL in BPH patients with OAB
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 .