Tags

Type your tag names separated by a space and hit enter

Adding Cyclooxygenase-2 inhibitor to alpha blocker for patients with benign prostate hyperplasia and elevated serum prostate specific antigen could not improve prostate biopsy detection rate but improve lower urinary tract symptoms.
Int J Clin Pract. 2013 Dec; 67(12):1327-33.IJ

Abstract

AIMS

To investigate the impact of cyclooxygenase-2 (COX-2) inhibitor with α-adrenoceptor blocker (α-blocker) for men with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) for detecting prostate cancer in men with elevated prostate specific antigen (PSA).

MATERIALS AND METHODS

Male patients with clinical BPH, elevated serum PSA (> 4 ng/ml), and significant LUTS (International Prostate Symptom Score [IPSS] ≥ 8) were randomly assigned to receive doxazosin 4 mg daily plus celecoxib 200 mg daily (study group) or doxazosin 4 mg daily alone (control group) for 3 months. Patients were investigated for the changes in IPSS, maximum flow rate (Qmax), voided volume, postvoid residual (PVR) volume and serum PSA from baseline to 3 months after treatment. After the 3-month therapy, prostate biopsy was performed in the patients whose PSA were still higher than 4 ng/ml.

RESULTS

A total of 82 patients completed the study. The improvement in IPSS-voiding was significantly greater in the study group than control group (p = 0.034). In the study group, patients with prostatic hyperplasia or inflammation on the prostate biopsy had a significantly better result than in patients with prostatic adenocarcinoma, typically in the changes of Qmax and voided volume (p = 0.012 and p = 0.005, respectively). The PSA level in the study group showed significant improvement after treatment (p < 0.01). However, prostate cancer detection rate failed to show any significant difference between the patients whose PSA levels decreased or not (6/21 = 29% vs. 5/24 = 20%, respectively, p = 0.447).

CONCLUSIONS

Treatment with COX-2 inhibitor and α-blocker for 3 months could not improve prostatic cancer detection rate. But it could increase therapeutic effectiveness of LUTS in men with BPH and elevated PSA levels. The changes in Qmax and voided volume after combination treatment were significantly greater in patients with prostatic hyperplasia or inflammation than adenocarcinoma.

Authors+Show Affiliations

Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

24246211

Citation

Jhang, J-F, et al. "Adding Cyclooxygenase-2 Inhibitor to Alpha Blocker for Patients With Benign Prostate Hyperplasia and Elevated Serum Prostate Specific Antigen Could Not Improve Prostate Biopsy Detection Rate but Improve Lower Urinary Tract Symptoms." International Journal of Clinical Practice, vol. 67, no. 12, 2013, pp. 1327-33.
Jhang JF, Jiang YH, Kuo HC. Adding Cyclooxygenase-2 inhibitor to alpha blocker for patients with benign prostate hyperplasia and elevated serum prostate specific antigen could not improve prostate biopsy detection rate but improve lower urinary tract symptoms. Int J Clin Pract. 2013;67(12):1327-33.
Jhang, J. F., Jiang, Y. H., & Kuo, H. C. (2013). Adding Cyclooxygenase-2 inhibitor to alpha blocker for patients with benign prostate hyperplasia and elevated serum prostate specific antigen could not improve prostate biopsy detection rate but improve lower urinary tract symptoms. International Journal of Clinical Practice, 67(12), 1327-33. https://doi.org/10.1111/ijcp.12220
Jhang JF, Jiang YH, Kuo HC. Adding Cyclooxygenase-2 Inhibitor to Alpha Blocker for Patients With Benign Prostate Hyperplasia and Elevated Serum Prostate Specific Antigen Could Not Improve Prostate Biopsy Detection Rate but Improve Lower Urinary Tract Symptoms. Int J Clin Pract. 2013;67(12):1327-33. PubMed PMID: 24246211.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adding Cyclooxygenase-2 inhibitor to alpha blocker for patients with benign prostate hyperplasia and elevated serum prostate specific antigen could not improve prostate biopsy detection rate but improve lower urinary tract symptoms. AU - Jhang,J-F, AU - Jiang,Y-H, AU - Kuo,H-C, PY - 2013/02/28/received PY - 2013/05/22/accepted PY - 2013/11/20/entrez PY - 2013/11/20/pubmed PY - 2014/7/8/medline SP - 1327 EP - 33 JF - International journal of clinical practice JO - Int J Clin Pract VL - 67 IS - 12 N2 - AIMS: To investigate the impact of cyclooxygenase-2 (COX-2) inhibitor with α-adrenoceptor blocker (α-blocker) for men with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) for detecting prostate cancer in men with elevated prostate specific antigen (PSA). MATERIALS AND METHODS: Male patients with clinical BPH, elevated serum PSA (> 4 ng/ml), and significant LUTS (International Prostate Symptom Score [IPSS] ≥ 8) were randomly assigned to receive doxazosin 4 mg daily plus celecoxib 200 mg daily (study group) or doxazosin 4 mg daily alone (control group) for 3 months. Patients were investigated for the changes in IPSS, maximum flow rate (Qmax), voided volume, postvoid residual (PVR) volume and serum PSA from baseline to 3 months after treatment. After the 3-month therapy, prostate biopsy was performed in the patients whose PSA were still higher than 4 ng/ml. RESULTS: A total of 82 patients completed the study. The improvement in IPSS-voiding was significantly greater in the study group than control group (p = 0.034). In the study group, patients with prostatic hyperplasia or inflammation on the prostate biopsy had a significantly better result than in patients with prostatic adenocarcinoma, typically in the changes of Qmax and voided volume (p = 0.012 and p = 0.005, respectively). The PSA level in the study group showed significant improvement after treatment (p < 0.01). However, prostate cancer detection rate failed to show any significant difference between the patients whose PSA levels decreased or not (6/21 = 29% vs. 5/24 = 20%, respectively, p = 0.447). CONCLUSIONS: Treatment with COX-2 inhibitor and α-blocker for 3 months could not improve prostatic cancer detection rate. But it could increase therapeutic effectiveness of LUTS in men with BPH and elevated PSA levels. The changes in Qmax and voided volume after combination treatment were significantly greater in patients with prostatic hyperplasia or inflammation than adenocarcinoma. SN - 1742-1241 UR - https://www.unboundmedicine.com/medline/citation/24246211/Adding_Cyclooxygenase_2_inhibitor_to_alpha_blocker_for_patients_with_benign_prostate_hyperplasia_and_elevated_serum_prostate_specific_antigen_could_not_improve_prostate_biopsy_detection_rate_but_improve_lower_urinary_tract_symptoms_ L2 - https://doi.org/10.1111/ijcp.12220 DB - PRIME DP - Unbound Medicine ER -