Can we use baseline characteristics to assess which men with moderately symptomatic benign prostatic hyperplasia at risk of progression will benefit from treatment? A post hoc analysis of data from the 2-year CONDUCT study

Claus Roehrborn, Igor Oyarzabal Perez, Erik P M Roos, Nicolae Calomfirescu, Betsy Brotherton, Juan Manuel Palacios, Averyan Vasylyev, Michael J. Manyak

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Purpose: To investigate (in a post hoc analysis of the 2-year CONDUCT study) the characteristics and clinical outcomes of men with moderately symptomatic benign prostatic hyperplasia (BPH) at risk of progression who benefitted from lifestyle changes alone. Methods: Patients were given lifestyle advice and randomized to a fixed-dose combination (FDC) of dutasteride and tamsulosin or watchful waiting (WW) and followed for 24 months. Patients in the WW group were escalated to tamsulosin if any follow-up International Prostate Symptom Score (IPSS) was equal or greater than the baseline value. Improvements in symptoms (change in IPSS) and quality of life [measured by BPH Impact Index (BII) and question 8 of the IPSS (IPSS-Q8)] were analysed in the FDC group, men who initiated tamsulosin (WW-TAM) and men who received no medical intervention (WW-no treatment) and the impact of baseline variables on IPSS determined. Results: The adjusted mean decrease in IPSS, BII and IPSS-Q8 at each post-baseline visit over 24 months appeared greater in the FDC (n = 369) and WW-no treatment groups (n = 144) than in the WW-TAM group (n = 229). IPSS improvements appeared similar in the FDC group and WW-no treatment subgroup, except in patients with the greatest degree of bother at baseline (BII 7–13). Conclusion: BII at baseline may be a more relevant indicator than symptom severity as to whether a patient with moderate symptoms should receive medical therapy or not.

Original languageEnglish (US)
Pages (from-to)421-427
Number of pages7
JournalWorld journal of urology
Volume35
Issue number3
DOIs
StatePublished - Mar 1 2017

Keywords

  • BPH Impact Index
  • Benign prostatic hyperplasia
  • Dutasteride
  • Lower urinary tract symptoms
  • Tamsulosin
  • Watchful waiting

ASJC Scopus subject areas

  • Urology

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