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Comparison of two alpha1-adrenoceptor antagonists, naftopidil and tamsulosin hydrochloride, in the treatment of lower urinary tract symptoms with benign prostatic hyperplasia: a randomized crossover study.
BJU Int. 2006 Apr; 97(4):747-51, discussion 751.BI

Abstract

OBJECTIVES

To compare the efficacy of two alpha(1)-adrenoceptor antagonists, alpha(1A)-adrenoceptor-selective tamsulosin hydrochloride and alpha(1D)-adrenoceptor-selective naftopidil, in the treatment of lower urinary tract symptoms (LUTS) with benign prostatic hyperplasia (BPH).

PATIENTS AND METHODS

Thirty-four patients (mean age 72.4 years, sd 4.3, range 66-79) with LUTS (International Prostate Symptom Score, IPSS >8) secondary to BPH were enrolled in a randomized crossover study. Seventeen patients were initially prescribed naftopidil 50 mg for 4 weeks, followed by tamsulosin 0.2 mg for 4 weeks (group A); another 17 were initially prescribed tamsulosin 0.2 mg, followed by naftopidil 50 mg (group B). Patients changed to the alternative treatment after a 1-week washout period. Efficacy criteria were improvement in LUTS (IPSS), quality of life (QoL), uroflowmetry, and pressure-flow study (PFS) values based on the treatment with each agent.

RESULTS

At baseline there were no significant differences between the groups in IPSS, QoL, uroflowmetry values or PFS values, except for the volume at maximum desire to void. After treatment with each agent, the IPSS and QoL were significantly improved and the reduction in bladder outlet obstruction confirmed by PFS. Naftopidil was significantly more effective than tamsulosin in relieving nocturia. The increases from baseline (before treatment) to the endpoint (after treatment with each agent) in the volume at first desire and maximum desire to void were significantly higher with naftopidil than with tamsulosin. Involuntary contractions disappeared in two patients with relief of nocturia with naftopidil, but not with tamsulosin. The decrease in other symptoms of the IPSS, QoL, increase in uroflowmetry values and changes in other PFS values were similar for both agents.

CONCLUSIONS

The two agents provided similar efficacy in the treatment of LUTS with BPH. However, naftopidil was better than tamsulosin for nocturia. The disappearance of involuntary contraction and the greater increase in first-desire volume with naftopidil may be associated with the relief of nocturia. The alpha(1D)-adrenoceptor antagonist is effective in alleviating both voiding and storage symptoms. The alpha(1D)-adrenoceptor antagonist may be more effective than the alpha(1A)-adrenoceptor antagonist in LUTS with BPH.

Authors+Show Affiliations

Department of Urology, Division of Disease Control, Research Field of Medical Sciences, Graduate School of Medicine, Gifu University, Japan. nishinoclinic-gifu@peace.ocn.ne.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16536766

Citation

Nishino, Yoshinori, et al. "Comparison of Two Alpha1-adrenoceptor Antagonists, Naftopidil and Tamsulosin Hydrochloride, in the Treatment of Lower Urinary Tract Symptoms With Benign Prostatic Hyperplasia: a Randomized Crossover Study." BJU International, vol. 97, no. 4, 2006, pp. 747-51, discussion 751.
Nishino Y, Masue T, Miwa K, et al. Comparison of two alpha1-adrenoceptor antagonists, naftopidil and tamsulosin hydrochloride, in the treatment of lower urinary tract symptoms with benign prostatic hyperplasia: a randomized crossover study. BJU Int. 2006;97(4):747-51, discussion 751.
Nishino, Y., Masue, T., Miwa, K., Takahashi, Y., Ishihara, S., & Deguchi, T. (2006). Comparison of two alpha1-adrenoceptor antagonists, naftopidil and tamsulosin hydrochloride, in the treatment of lower urinary tract symptoms with benign prostatic hyperplasia: a randomized crossover study. BJU International, 97(4), 747-51, discussion 751.
Nishino Y, et al. Comparison of Two Alpha1-adrenoceptor Antagonists, Naftopidil and Tamsulosin Hydrochloride, in the Treatment of Lower Urinary Tract Symptoms With Benign Prostatic Hyperplasia: a Randomized Crossover Study. BJU Int. 2006;97(4):747-51, discussion 751. PubMed PMID: 16536766.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of two alpha1-adrenoceptor antagonists, naftopidil and tamsulosin hydrochloride, in the treatment of lower urinary tract symptoms with benign prostatic hyperplasia: a randomized crossover study. AU - Nishino,Yoshinori, AU - Masue,Takako, AU - Miwa,Kousei, AU - Takahashi,Yoshito, AU - Ishihara,Satoshi, AU - Deguchi,Takashi, PY - 2006/3/16/pubmed PY - 2006/4/25/medline PY - 2006/3/16/entrez SP - 747-51, discussion 751 JF - BJU international JO - BJU Int VL - 97 IS - 4 N2 - OBJECTIVES: To compare the efficacy of two alpha(1)-adrenoceptor antagonists, alpha(1A)-adrenoceptor-selective tamsulosin hydrochloride and alpha(1D)-adrenoceptor-selective naftopidil, in the treatment of lower urinary tract symptoms (LUTS) with benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: Thirty-four patients (mean age 72.4 years, sd 4.3, range 66-79) with LUTS (International Prostate Symptom Score, IPSS >8) secondary to BPH were enrolled in a randomized crossover study. Seventeen patients were initially prescribed naftopidil 50 mg for 4 weeks, followed by tamsulosin 0.2 mg for 4 weeks (group A); another 17 were initially prescribed tamsulosin 0.2 mg, followed by naftopidil 50 mg (group B). Patients changed to the alternative treatment after a 1-week washout period. Efficacy criteria were improvement in LUTS (IPSS), quality of life (QoL), uroflowmetry, and pressure-flow study (PFS) values based on the treatment with each agent. RESULTS: At baseline there were no significant differences between the groups in IPSS, QoL, uroflowmetry values or PFS values, except for the volume at maximum desire to void. After treatment with each agent, the IPSS and QoL were significantly improved and the reduction in bladder outlet obstruction confirmed by PFS. Naftopidil was significantly more effective than tamsulosin in relieving nocturia. The increases from baseline (before treatment) to the endpoint (after treatment with each agent) in the volume at first desire and maximum desire to void were significantly higher with naftopidil than with tamsulosin. Involuntary contractions disappeared in two patients with relief of nocturia with naftopidil, but not with tamsulosin. The decrease in other symptoms of the IPSS, QoL, increase in uroflowmetry values and changes in other PFS values were similar for both agents. CONCLUSIONS: The two agents provided similar efficacy in the treatment of LUTS with BPH. However, naftopidil was better than tamsulosin for nocturia. The disappearance of involuntary contraction and the greater increase in first-desire volume with naftopidil may be associated with the relief of nocturia. The alpha(1D)-adrenoceptor antagonist is effective in alleviating both voiding and storage symptoms. The alpha(1D)-adrenoceptor antagonist may be more effective than the alpha(1A)-adrenoceptor antagonist in LUTS with BPH. SN - 1464-4096 UR - https://www.unboundmedicine.com/medline/citation/16536766/Comparison_of_two_alpha1_adrenoceptor_antagonists_naftopidil_and_tamsulosin_hydrochloride_in_the_treatment_of_lower_urinary_tract_symptoms_with_benign_prostatic_hyperplasia:_a_randomized_crossover_study_ L2 - https://doi.org/10.1111/j.1464-410X.2006.06030.x DB - PRIME DP - Unbound Medicine ER -