Researchers assessed the efficacy and safety of a combination therapy of two different α-blockers, Cardura (doxazosin) and Flomax (tamsulosin), with Detrol (tolterodine), as evidence supports the superiority of this strategy over a single therapy for the treatment of men with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH).
The findings point to a significant improvement with the combination of Cardura and Detrol.
The research paper, “A Randomized, Open-Label, Comparative Study of Efficacy and Safety of Tolterodine Combined with Tamsulosin or Doxazosin in Patients with Benign Prostatic Hyperplasia,” was published in Medical Science Monitor.
Muscarinic receptor antagonists, such as Detrol, reduce the contraction of the bladder and are widely used to treat overactive bladder (OAB) symptoms. Their combination with other medicines may lead to a significant improvements of LUTS, especially in patients that still suffer even after being treated with α-blockers or 5 α-reductase inhibitors.
Previous studies have suggested there are benefits in using antimuscarinic drugs in combination with α-blockers in a select population of patients with LUTS secondary to BPH. However, it is unclear if using different α-blockers will produce different results in terms of efficacy and safety.
The study included 220 men diagnosed with BPH and LUTS who received, for 12 weeks, either 4 mg Cardura and Detrol extended release (ER) 4 mg per day (Cardura group) or Flomax 0.2 mg and Detrol ER 4 mg per day (Flomax group).
The primary endpoint was the assessment of changes in the international prostatic symptom score (IPSS), while secondary endpoints included quality of life (QoL), maximum flow rate (Qmax) and urodynamic parameters, assessed at different points during the study.
The trial was completed by 192 patients and, at the beginning of the study, no differences were found between patients in the different groups. After six weeks of treatment, however, IPSS improved in both groups, while QoL improved significantly in the Cardura group, compared to the Flomax group.
After 12 weeks, Qmax, IPSS, QoL, intravesical pressure (Pves), and bladder compliance (BC) were significantly improved in the Cardura group.
“In conclusion, combined therapy improves symptoms in patients with BPH with a significant presence of irritative symptoms. The good tolerability and improved symptoms resulting from combined treatment may provide improvement in LUTS for patients without bladder obstruction symptoms,” the researchers concluded.