Combination therapy provides continuous BPH symptom improvement

Combination treatment with the 5-alpha-reductase inhibitor dutasteride (Avodart) and the alpha-blocker tamsulosin (Flomax) provides significantly greater urinary symptom improvement for men with BPH than either therapy alone does over 24 months, according to a study presented at the recent meeting of the Société Internationale d’Urologie in Paris.

CombAT (combination therapy with Avodart and tamsulosin) is a 4-year, multicenter, randomized, double-blind, parallel-group study. It includes 4,800 men with moderate-to-severe BPH symptoms. All study participants received placebo for 4 weeks, then were randomized to receive dutasteride and tamsulosin combination therapy, dutasteride monotherapy, or tamsulosin monotherapy.

Over 24 months, dutasteride and tamsulosin combination therapy provided a significantly greater improvement in symptoms from baseline than either dutasteride or tamsulosin treatment alone did (p<.001). In fact, the study demonstrated the benefit of combination therapy over both monotherapies in the first 12 months of treatment. With combination therapy, patients experienced continuous improvement of symptoms throughout the 2 years of the study.

By comparison, patients taking tamsulosin showed similar symptom improvement from month 3 to month 24, and dutasteride resulted in continuous and sustained maximum flow rate improvements to month 24.

“This trial suggests that physicians should consider combining dutasteride and tamsulosin as initial therapy to achieve improved symptom relief for men with enlarged prostate,” said Claus G. Roehrborn, MD, of the University of Texas Southwestern, Dallas, who presented the data. “This study provides important new data to guide medical therapy for men with symptomatic BPH.”

At the end of 4 years, researchers will issue a final report regarding the efficacy of the drugs in reducing the risk of symptomatic disease progression and the risk of acute urinary retention.