Early symptom improvement and discontinuation of 5-α-reductase inhibitor (5ARI) therapy in patients with benign prostatic hyperplasia (BPH)
| Autor: | Emily Phillips, Susan Hogue, Michael Eaddy, Eric J. Kruep |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Combination therapy Prostatic Hyperplasia 5-alpha Reductase Inhibitors Lower Urinary Tract Symptoms Internal medicine medicine Humans Pharmacology (medical) Medical prescription Survival analysis Adrenergic alpha-Antagonists Aged Retrospective Studies Gynecology business.industry Hyperplasia Middle Aged medicine.disease Survival Analysis Discontinuation Symptom improvement Propensity score matching Disease Progression Drug Therapy Combination Benign prostatic hyperplasia (BPH) business |
| Zdroj: | The Annals of pharmacotherapy. 48(3) |
| ISSN: | 1542-6270 |
| Popis: | Background: Pharmacological treatment options for benign prostatic hyperplasia (BPH) commonly include α-blocker (AB) and 5-α-reductase inhibitor (5ARI) agents, which have separate but important attributes that carry clinical implications in terms of improvement of lower–urinary tract symptoms (LUTS) and clinical disease progression. Objectives: This study hypothesized that administering AB therapy concomitantly with newly started 5ARI treatment would reduce the likelihood of 5ARI discontinuation through early symptom improvement. Methods: This retrospective analysis of the PharMetrics Integrated Medical and Pharmaceutical Database included men aged ≥50 years with ≥1 medical claim of BPH diagnosis and ≥1 prescription claim of a 5ARI with or without an AB. Patients initiating 5ARI monotherapy were propensity score matched with patients initiating combination AB + 5ARI therapy (1:1), with 5ARI time to discontinuation (30-day gap in treatment) compared between groups utilizing survival analysis techniques. The percentage of patients adherent to 5ARI therapy based on medication possession ratio (MPR) was assessed. Results: After 180 days of follow-up, 61.7% of the combination therapy arm versus 59.2% of the monotherapy arm remained on therapy. Combination therapy patients were 10% less likely to discontinue 5ARI treatment (hazard ratio = 0.904; P = .006) and were more likely to be adherent when adherence was defined as MPR ≥70% and ≥75%. Conclusions: Based on an assessment of claims data, initiating AB with 5ARI therapy is associated with a lower rate of 5ARI discontinuation compared with 5ARI monotherapy. Early symptom relief from AB therapy may contribute to a lower discontinuation rate for concomitant 5ARI therapy. |
| Databáze: | OpenAIRE |
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