Efficacy and Safety of Combined Oral Therapy with Tadalafil andAlfuzosin: An Integrated Approach to the Management of Patientswith Lower Urinary Tract Symptoms and Erectile Dysfunction.Preliminary Report
| Autor: | Emanuele Belgrano, Giuseppe Maio, Giorgio Pomara, Giovanni Liguori, Giangiacomo Ollandini, Daniele Vecchio, Carlo Trombetta, Stefano Bucci, Giuseppe Ocello, Gioacchino De Giorgi |
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| Přispěvatelé: | Liguori, Giovanni, Trombetta, Carlo, De Giorgi, G, Pomara, G, Maio, G, Vecchio, D, Ocello, G, Ollandini, G, Bucci, S, Belgrano, Emanuele |
| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
Male
Urologic Diseases medicine.medical_specialty Combination therapy Phosphodiesterase Inhibitors erectile dysfunction Urology Endocrinology Diabetes and Metabolism Administration Oral alfuzosin Endocrinology Quality of life Lower urinary tract symptoms medicine Humans Alfuzosin Adrenergic alpha-Antagonists Aged business.industry Integrated approach Middle Aged medicine.disease Tadalafil Psychiatry and Mental health Erectile dysfunction Treatment Outcome Reproductive Medicine cGMP-specific phosphodiesterase type 5 tadalafil Quinazolines Drug Therapy Combination business medicine.drug Carbolines |
| Popis: | Introduction Alpha1-blockers (AB) are the first-line monotherapy for lower urinary tract symptoms (LUTS). Phosphodiesterase type 5 (PDE5) inhibitors are the first-line treatment for erectile dysfunction (ED). Numerous studies have supposed a significant association between ED and LUTS, but a causal relationship cannot be established. Aim The aim was to evaluate the efficacy of a combined therapy with an AB (alfuzosin) and PDE5 inhibitors (tadalafil) in patients with LUTS and ED. Methods This was a randomized, open-label, three-arm study. A total of 66 men complaining of ED and LUTS were included in the study. Patients were assessed at baseline and after 12 weeks of study treatment, and then underwent randomized allocation to either alfuzosin 10 mg once a day (22 patients) or tadalafil 20 mg on alternative days (21 patients), or a combination of both (23 patients). Main Outcome Measures All participants completed the erectile function domain of the International Index of Erectile Function (IIEF-EF) and the International Prostatic Symptom Score (IPSS). Other efficacy variables included maximum urinary flow rate (Qmax) and medium urinary flow rate (Qave). Results IIEF-EF tended to improve with alfuzosin alone (+15%), while it was clearly improved with tadalafil alone (+36.3%). The greatest improvement was experienced with the combination therapy (+37.6%). Improvement in Qmax was observed in all groups, but patients receiving combination therapy had greater improvement (29.6%) than patients receiving either only alfuzosin (21.7%) or only tadalafil (9.5%). IPSS was significantly improved in alfuzosin group (27.2%), was more marked with the combination therapy (41.6%), and a small increase, although not significant, was also observed with tadalafil (8.4%). Conclusions Combined therapy improved ED and LUTS as demonstrated by the significant improvement in uroflowmetry measures and in IPSS and IIEF-EF scores. A significant improvement was also observed in quality of life assessments. The beneficial effects of tadalafil on LUTS similar to the benefits of alfuzosin on ED, although present, were smaller. Liguori G, Trombetta C, Giorgi GD, Pomara G, Maio G, Vecchio D, Ocello G, Ollandini G, Bucci S, and Belgrano E. Efficacy and safety of combined oral therapy with tadalafil and alfuzosin: An integrated approach to the management of patients with lower urinary tract symptoms and erectile dysfunction. Preliminary report. J Sex Med 2009;6:544–552. |
| Databáze: | OpenAIRE |
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