Two-drug therapy improves BPH symptoms

Men with BPH who take a combination of dutasteride (Avodart) and tamsulosin (Flomax) appear to experience significantly greater improvement in urinary symptoms than do men taking either medication alone, according to findings from the CombAT (Combination of Avodart and Tamsulosin) study.

“CombAT is an important contribution to our evolving understanding of the management of enlarged prostate,” said Steven A. Kaplan, MD, of Weill-Cornell Medical College, New York. “In this study, combination therapy yielded greater improvement in symptom score than either monotherapy within the first year of treatment, which appears to be a new finding. We then see in CombAT that this treatment difference holds true through month 24.”

In the study, to be published in the February 2008 Journal of Urology, 4,844 patients with moderate to severe BPH symptoms received placebo for 4 weeks and then were randomized to receive dutasteride and tamsulosin as combination therapy, dutasteride monotherapy, or tamsulosin monotherapy. The primary endpoint was a change in International Prostate Symptom Score from baseline and at month 24 for combination therapy compared with each medication alone.

Results at month 24 showed that combination therapy demonstrated significantly greater symptom improvement (p<.001) than either monotherapy. The mean decrease in IPSS from baseline was 6.2 points for combination therapy compared with 4.9 and 4.3 points for dutasteride and tamsulosin, respectively.