Although additional well design ed , worldwide , placebo-controlled and r and omized studies are necessary to confirm the long-term outcomes of naftopidil pharmacotherapy , current data suggest that naftopidil administration in BPH patients provides comparable improvements in total IPSS , QoL , and urinary symptoms from baseline relative to 0.2 mg/d tamsulosin and 8 mg/d silodosin .
However , improvements in Qmax are generally less with naftopidil than with tamsulosin .
Reported adverse effects related to naftopidil administration are negligible and usually mild .
OBJECTIVES The aim of the study was to systematic ally review the effects of the adrenoreceptor A1D antagonist naftopidil in the management of  lower urinary tract symptoms ( LUTS ) .
Short-term efficacy and long-term compliance/treatment failure of the alpha1 blocker naftopidil for patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia.
OBJECTIVE To evaluate treatment failure during a 4-year follow-up period after administration of naftopidil for patients with lower urinary tract symptoms ( LUTS ) suggestive of benign prostatic hyperplasia ( BPH ) in real-life clinical practice . MATERIAL AND METHODS A total of 247 patients with LUTS/BPH who had an International Prostate Symptom Score ( IPSS ) of > or = 8 were enrolled in the study .  Naftopidil , 50 mg/day , was given to the patients . They were followed for 4 years with periodic evaluation . Treatment failure was defined as conversion to other medical treatment or to surgery . RESULTS Of the 247 patients , treatment failure occurred in 42 ( 17.0 % ) during the 4-year follow-up period . The 4-year treatment failure rate was on the Kaplan-Meier curve 35.0 % . Among parameters assessed at baseline , prostate volume ( PV ) was the only significant determinant of treatment failure : patients with a PV of > or = 35 ml had a 2.1 times higher hazard of treatment failure than those with a PV of < 35 ml ( 95 % CI 1.06 - 4.33 ; p=0.03 ) . Patients with a severe IPSS at 12 weeks after administration of naftopidil had a 3.5 times higher hazard than those having a mild/moderate IPSS ( 95 % CI 1.34 - 9.26 ; p=0.01 ) . After 4 years , 200 patients ( 81 % ) had stopped taking naftopidil because of adverse events , treatment failure , loss to follow-up , etc . CONCLUSIONS There were significant improvements in IPSS and urinary flow rate with naftopidil although it is unknown whether these improvements were significantly larger than the placebo effect as the study was non-r and omized . However , only 19 % of patients were known to have continued with the same medication for 4 years in real-life clinical practice . Patients who have a large prostate at baseline and a severe IPSS at 12 weeks after treatment are more likely to have treatment failure , although a prospect i ve study is needed to confirm this
Although additional well design ed , worldwide , placebo-controlled and r and omized studies are necessary to confirm the long-term outcomes of naftopidil pharmacotherapy , current data suggest that naftopidil administration in BPH patients provides comparable improvements in total IPSS , QoL , and urinary symptoms from baseline relative to 0.2 mg/d tamsulosin and 8 mg/d silodosin .
However , improvements in Qmax are generally less with naftopidil than with tamsulosin .
Reported adverse effects related to naftopidil administration are negligible and usually mild .
OBJECTIVES The aim of the study was to systematic ally review the effects of the adrenoreceptor A1D antagonist naftopidil in the management of  lower urinary tract symptoms ( LUTS ) .