Large-scale BPH studies: Data are forthcoming

The major discussions of advances in understanding and treating BPH may take place in the hallways rather than in the official meeting rooms during this month's AUA annual meeting, Claus G. Roehrborn, MD, professor and chairman of the department of urology at the University of Texas Southwestern Medical Center, Dallas, told Urology Times.

It is a matter of timing. Major studies of therapies for lower urinary tract symptoms and BPH are underway, but the data they produce will not be available until late summer or the end of the year at the earliest.

"That is where the buzz is," said Dr. Roehrborn, referring to the several different studies.

PDE-5 inhibitors for LUTS/BPH

The medical applications of botulinum toxin (Botox) may expand to include BPH, noted Dr. Roehrborn. At least one study of the toxin suggests that intraprostatic injections can improve LUTS and BPH. The agent does not appear to reduce prostatic volume, and, as with PDE-5 inhibitors, its mechanisms of action remain to be described.

"The National Institute of Diabetes and Digestive and Kidney Diseases is funding a large study that may define the role of Botox in patients with LUTS and BPH. That will no doubt add to the level of hallway discussion of the agent," Dr. Roehrborn said.

Boston appears to be a hotbed of epidemiology. A study team from the city will present close to a dozen different papers on data gathered from the Boston Area Community Health (BACH) survey and the Massachusetts Male Aging Studies (MMAS). The MMAS is well established, but the BACH endeavor is new. Its investigators intend to look at all aspects of urologic problems (including BPH and LUTS) and associated therapies, which affect 6,000 men in the greater Boston area. The investigators are establishing three equal cohorts of African-American, Hispanic, and Caucasian men for ethnic comparative study.

At least one other major investigation is underway that will fuel discussion and speculation.

"Another study that is pending, but not yet complete, is the COMBAT study. It is a four-year study of dutasteride (Avodart) alone or in combination with tamsulosin (Flomax)," said Dr. Roehrborn.

The four-year, multicenter, international study of men with BPH began 2 years ago in the United States, and researchers hope to enroll 4,500 patients here and abroad.