Combination therapy offers benefits for men with BPH

Final results from a large, 4-year study shows that combination treatment with dutasteride (Avodart) and tamsulosin (Flomax) reduces the risk of acute urinary retention or BPH-related surgery and reduces the risk of BPH clinical progression more than tamsulosin alone.

Results from the Combination therapy with Avodart and tamsulosin (CombAT) study also showed that combination treatment delivered sustained symptom improvement from month 9 compared with either drug alone.

"[The CombAT study] provides evidence that dutasteride and tamsulosin together may benefit [men with BPH], potentially reducing the long-term risk of disease progression and improving their symptoms," said principal investigator Claus G. Roehrborn, MD, of the University of Texas Southwestern Medical Center, Dallas.

The study results, which were published online in European Urology (Sept. 19, 2009), showed a significant 66% reduction in the risk of acute retention or BPH-related surgery with combination treatment compared with tamsulosin (pp=.18). The risk of BPH clinical progression with combination treatment was reduced by 44% compared with tamsulosin and 31% for those on dutasteride.

Men in the study who had moderate to severe symptoms of BPH at enrollment reported a significant improvement in BPH symptoms at 4 years, with a mean change from baseline of -6.3 points compared with -3.8 for tamsulosin and -5.3 for dutasteride alone, as measured by the International Prostate Symptom Score.

The combination therapy was generally well tolerated, and most reported drug-related adverse events were as anticipated from the known safety profiles of the two drugs, with erectile dysfunction and retrograde ejaculation as the most commonly reported drug-related adverse events.