Rate and associated factors of solifenacin add-on after tamsulosin monotherapy in men with voiding and storage lower urinary tract symptoms.

Abstract

AIM:

To explore the rate of add-on therapy with solifenacin in men with voiding and storage lower urinary tract symptoms (LUTS) after tamsulosin monotherapy and to explore predictive factors for starting solifenacin add-on therapy.

METHODS:

Men aged ≥ 45 years with IPSS ≥ 12 and symptoms of OAB (OAB-V8 ≥ 8, micturition ≥ 8/24 h, urgency ≥ 2/24 h) were enrolled to receive tamsulosin 0.2 mg once daily. After 4 weeks, men with residual symptoms of OAB and reported 'dissatisfied' or 'a little satisfied' were received solifenacin 5 mg in combination with tamsulosin monotherapy. Subjects completed an IPSS, a Quality of life (QoL) index, OAB V8, and an International Consultation of Incontinence Questionnaire (ICIQ)-Male LUTS, and patient perception of bladder condition (PPBC) at baseline and week 4.

RESULTS:

Of a total of 305 patients, 254 patients completed 4 weeks of tamsulosin treatment. For 176 patients, solifenacin was added (69.3%). Significant predictive factors of solifenacin add-on therapy included long LUTS duration, high IPSS, number of micturitions per 24 h, more urgency episodes, high urgency severity score in a voiding diary and high OAB V8 score. Based on multivariable analysis, potential predictive factors of solifenacin add-on therapy included long LUTS duration (OR = 1.008, 95% CI: 1.001-1.014), high serum PSA (OR = 1.543, 95% CI: 1.136-2.095) and small prostate size (OR = 0.970, 95% CI: 0.947-0.994) (p < 0.05). IPSS, daytime micturitions and urgency episodes, OAB V8 scores, ICIQ and PPBC were improved after tamsulosin monotherapy.

CONCLUSIONS:

Two thirds of men with voiding and storage LUTS needed to add anticholinergics after 4 weeks of tamsulosin monotherapy. Patients with longer lasting symptoms and storage symptoms with small prostate volume may require the anticholinergic add-on.

• Authors: H N Lee, K-S Lee, J C Kim, B H Chung, C-S Kim, J G Lee, D K Kim, C H Park, J K Park, S J Hong
• Journal: International journal of clinical practice (Int J Clin Pract) Vol. 69 Issue 4 Pg. 444-53 (Apr 2015) ISSN: 1742-1241 [Electronic] India
• PMID: 25363606 (Publication Type: Clinical Trial, Phase IV, Journal Article, Multicenter Study, Observational Study)
• Copyright: © 2014 John Wiley & Sons Ltd.

Chemical References

• Adrenergic alpha-1 Receptor Antagonists
• Muscarinic Antagonists
• Sulfonamides
• Urological Agents
• Tamsulosin
• Solifenacin Succinate

Topics

• Adrenergic alpha-1 Receptor Antagonists (therapeutic use)
• Aged
• Aged, 80 and over
• Drug Therapy, Combination
• Humans
• Male
• Middle Aged
• Muscarinic Antagonists (therapeutic use)
• Prospective Studies
• Quality of Life
• Solifenacin Succinate (therapeutic use)
• Sulfonamides (therapeutic use)
• Tamsulosin
• Urinary Bladder, Overactive (drug therapy)
• Urological Agents (therapeutic use)