Effect of Use or Withdrawal of AB or 5ARI in LUTS BPH

Effect of use or withdrawal of AB or 5ARI in LUTS/BPH

<h2 id="aim">Aim</h2><p>Investigate withdrawal effects of al-adrenergic receptor blocker (AB) or 5a-reductase inhibitor (5ARl) following successful combination therapy.</p><h2 id="method">Method</h2><ul><li>222 patients with BPH/LUTS were enrolled, with at least a seven-point improvement in International Prostate Symptom Score-total (IPSS-T) and a 2 20% reduction in Prostate volume (PV) with combination therapy.</li><li>Patients were randomized in a 1:1:1 ratio into continued-combination, AB-withdrawal, and 5ARl-withdrawal groups.</li><li>Assessment every 6 months for 24 months: IPSS, overactive bladder symptom score, EuroQol-five-dimensional questionnaire (EQ-5D-5L), EuroQol-visual analog scale (EQ-VAS), PV, maximal flow rate, Postvoid residual urine (PVR), and prostate-specific antigen level.</li><li>Evaluated the predictors of IPSS-T deterioration.</li></ul><h2 id="results">Results</h2><ul><li>At 24 months, IPSS-T deterioration (22 point) was observed in 27.8% and 26.4% patients in the AB- and 5ARl-withdrawal groups, respectively (Figure).</li><li>In the continued combination group, EQ-VAS improved at Month 24 compared to baseline (p = 0.028).</li></ul><p style="text-align:center;"><img src="https://cdn.megawecare.com/GHBY/Internal-Images/rates_of_international.png" width="876" height="500" alt="Rates of International Prostate Symptom Score total score deterioration"></p><h2 id="conclusion">Conclusion</h2><p>In patients with BPH/LUTS who are unwilling to continue combination therapy,<br>AB or 5ARI withdrawal can be offered in men with improvement in IPSS-T by at<br>least seven points and reduction in PV by at least 20%.</p>

Urology Update   Issue 1   Jan 2024   Final

<ul><li><a href="#aim">Aim</a></li><li><a href="#method">Methods</a></li><li><a href="#results">Results</a></li><li><a href="#conclusion">Conclusion</a></li></ul>