Impact of cardiovascular risk factors and related comorbid conditions and medical therapy reported at baseline on the treatment response to tadalafil 5 mg once-daily in men with lower urinary tract symptoms associated with benign prostatic hyperplasia: an
Autor: | C. Vlachopoulos, A. Esler, Gerald B. Brock, John P. Mulhall, M. T. Rosenberg, Matthias Oelke, Hartwig Büttner, Mario Maggi |
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Rok vydání: | 2015 |
Předmět: |
Male
medicine.medical_specialty medicine.drug_class Vasodilator Agents Prostatic Hyperplasia Comorbidity urologic and male genital diseases Placebo Drug Administration Schedule Tadalafil law.invention Double-Blind Method Lower Urinary Tract Symptoms Randomized controlled trial Risk Factors law Lower urinary tract symptoms Internal medicine Post-hoc analysis Humans Medicine Antihypertensive drug Aged Aged 80 and over Gynecology business.industry General Medicine Middle Aged Phosphodiesterase 5 Inhibitors medicine.disease Clinical trial Cardiovascular Diseases International Prostate Symptom Score business medicine.drug |
Zdroj: | International Journal of Clinical Practice. 69:1496-1507 |
ISSN: | 1368-5031 |
DOI: | 10.1111/ijcp.12722 |
Popis: | Summary Purpose The influence of cardiovascular risk factors/comorbidities on response to oral once-daily tadalafil 5 mg was explored in men with lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH). Methods This post hoc analysis pooled data from four double-blind studies in which 1498 men with > 6-mo history of LUTS/BPH were randomised and received either once-daily placebo (n = 746) or tadalafil 5 mg (n = 752) for 12 weeks. Descriptive statistics were reported for changes in total International Prostate Symptom Score (IPSS), IPSS voiding and storage subscores, and IPSS quality-of-life (QoL) index. Treatment group differences by baseline clinical and cardiovascular factors and medical therapies were examined using analysis of covariance. Results Tadalafil was effective in men with LUTS/BPH and cardiovascular risk factors/comorbidities except for patients receiving > 1 antihypertensive medication. Placebo-adjusted least squares (LS) mean improvements in total IPSS were −1.2 (95% CI: −2.5 to −0.0) in men taking > 1 antihypertensive medication vs. −3.3 (95% CI: −4.4 to −2.1) in men taking one medication (interaction p = 0.020). In addition, placebo-adjusted LS mean improvements in total IPSS were −0.2 (95% CI, −2.1 to 1.7) in men who reported use of diuretics vs. −2.8 (95% CI, −3.7 to −1.9) in men who reported taking other antihypertensive medications vs. −2.3 (95% CI, −3.2 to −1.5) in men who reported not using any antihypertensive drug (p-value for interaction = 0.053). Conclusions Once-daily tadalafil 5 mg improved LUTS/BPH, regardless of severity, in men with coexisting cardiovascular risk factors/comorbidities, except for patients with history of > 1 drug for arterial hypertension. Use of diuretics may contribute to patients’ perception of a negated efficacy of tadalafil on LUTS/BPH. Comorbidities should be considered when choosing the optimal medicine to treat men with LUTS/BPH. |
Databáze: | OpenAIRE |
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