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Lower Urinary Tract Symptoms: What's New in Medical Treatment?
Eur Urol Focus. 2018 01; 4(1):17-24.EU

Abstract

CONTEXT

Pharmacological treatment is a cornerstone in the management of patients with lower urinary tract symptoms (LUTS).

OBJECTIVE

To review emerging evidence in the medical treatment of LUTS.

EVIDENCE ACQUISITION

An Embase/Pubmed-based literature search was conducted in December 2017, screening for randomized controlled trials (RCTs), prospective and retrospective series, animal model studies, and reviews on medical treatment of LUTS.

EVIDENCE SYNTHESIS

The main medical innovation in recent years in overactive bladder (OAB) has been the approval of the first β3-adrenoceptor agonists (mirabegron) and intradetrusor onabotulinum toxin A, while several other drugs such as antiepileptics, phosphodiesterase inhibitors, or other β3-agonists have brought promising results in phase 3 trials. Intraprostatic injections of various drugs for LUTS/benign prostatic hyperplasia have been investigated, but results of phase 3 trials are still pending, while combination therapies of phosphodiesterase type 5 inhibitors+α-blockers or finasteride have been proved as superior to single therapies in RCTs conducted in these patients. Two new formulations of desmopressin have been approved for nocturia in the USA (desmopressin nasal spray) and Europe/Canada/Australia (desmopressin orally disintegrated tablet). Fedovapagon, a vasopressin V2 receptor agonist, has recently completed a large phase 3 trial in male patients with nocturia. Other phase 3 trials are ongoing in bladder pain syndrome (AQX 11-25, a SHIP-1 activator) and in neurogenic detrusor overactivity (mirabegron and abobotulinum toxin A).

CONCLUSIONS

Medical treatment of LUTS is a very active research field with recently approved drugs for nocturia (desmopressin acetate nasal spray/orally disintegrated tablet) and numerous emerging drugs currently investigated in OAB, LUTS/benign prostatic hyperplasia, nocturia, bladder pain syndrome, and neurogenic detrusor overactivity.

PATIENT SUMMARY

Medical treatment of lower urinary tract symptoms is a very active research field with recently approved drugs for nocturia (desmopressin acetate nasal spray/orally disintegrated tablet) and numerous emerging drugs in overactive bladder, nocturia, neurogenic detrusor overactivity, bladder pain syndrome, or benign prostatic hyperplasia.

Authors+Show Affiliations

Department of Urology, University of Rennes, Rennes, France. Electronic address: benoit.peyronnet@nyumc.org.Department of Urology, New York University, New York, NY, USA.Department of Pharmacology, Johannes Gutenberg University, Mainz, Germany.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

29665997

Citation

Peyronnet, Benoit, et al. "Lower Urinary Tract Symptoms: What's New in Medical Treatment?" European Urology Focus, vol. 4, no. 1, 2018, pp. 17-24.
Peyronnet B, Brucker BM, Michel MC. Lower Urinary Tract Symptoms: What's New in Medical Treatment? Eur Urol Focus. 2018;4(1):17-24.
Peyronnet, B., Brucker, B. M., & Michel, M. C. (2018). Lower Urinary Tract Symptoms: What's New in Medical Treatment? European Urology Focus, 4(1), 17-24. https://doi.org/10.1016/j.euf.2018.04.005
Peyronnet B, Brucker BM, Michel MC. Lower Urinary Tract Symptoms: What's New in Medical Treatment. Eur Urol Focus. 2018;4(1):17-24. PubMed PMID: 29665997.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lower Urinary Tract Symptoms: What's New in Medical Treatment? AU - Peyronnet,Benoit, AU - Brucker,Benjamin M, AU - Michel,Martin C, Y1 - 2018/04/14/ PY - 2018/02/16/received PY - 2018/03/06/revised PY - 2018/04/01/accepted PY - 2018/4/19/pubmed PY - 2019/2/13/medline PY - 2018/4/19/entrez KW - Drug KW - Lower urinary tract symptoms KW - Overactive KW - Prostatic hyperplasia KW - Urinary bladder KW - Urinary incontinence SP - 17 EP - 24 JF - European urology focus JO - Eur Urol Focus VL - 4 IS - 1 N2 - CONTEXT: Pharmacological treatment is a cornerstone in the management of patients with lower urinary tract symptoms (LUTS). OBJECTIVE: To review emerging evidence in the medical treatment of LUTS. EVIDENCE ACQUISITION: An Embase/Pubmed-based literature search was conducted in December 2017, screening for randomized controlled trials (RCTs), prospective and retrospective series, animal model studies, and reviews on medical treatment of LUTS. EVIDENCE SYNTHESIS: The main medical innovation in recent years in overactive bladder (OAB) has been the approval of the first β3-adrenoceptor agonists (mirabegron) and intradetrusor onabotulinum toxin A, while several other drugs such as antiepileptics, phosphodiesterase inhibitors, or other β3-agonists have brought promising results in phase 3 trials. Intraprostatic injections of various drugs for LUTS/benign prostatic hyperplasia have been investigated, but results of phase 3 trials are still pending, while combination therapies of phosphodiesterase type 5 inhibitors+α-blockers or finasteride have been proved as superior to single therapies in RCTs conducted in these patients. Two new formulations of desmopressin have been approved for nocturia in the USA (desmopressin nasal spray) and Europe/Canada/Australia (desmopressin orally disintegrated tablet). Fedovapagon, a vasopressin V2 receptor agonist, has recently completed a large phase 3 trial in male patients with nocturia. Other phase 3 trials are ongoing in bladder pain syndrome (AQX 11-25, a SHIP-1 activator) and in neurogenic detrusor overactivity (mirabegron and abobotulinum toxin A). CONCLUSIONS: Medical treatment of LUTS is a very active research field with recently approved drugs for nocturia (desmopressin acetate nasal spray/orally disintegrated tablet) and numerous emerging drugs currently investigated in OAB, LUTS/benign prostatic hyperplasia, nocturia, bladder pain syndrome, and neurogenic detrusor overactivity. PATIENT SUMMARY: Medical treatment of lower urinary tract symptoms is a very active research field with recently approved drugs for nocturia (desmopressin acetate nasal spray/orally disintegrated tablet) and numerous emerging drugs in overactive bladder, nocturia, neurogenic detrusor overactivity, bladder pain syndrome, or benign prostatic hyperplasia. SN - 2405-4569 UR - https://www.unboundmedicine.com/medline/citation/29665997/Lower_Urinary_Tract_Symptoms:_What's_New_in_Medical_Treatment L2 - https://linkinghub.elsevier.com/retrieve/pii/S2405-4569(18)30094-4 DB - PRIME DP - Unbound Medicine ER -