If your benign prostatic hyperplasia (BPH) symptoms have not been relieved by treatment with a single medication, combination therapy is worth a try, according to data reported in The Journal or Urology (Volume 179, page 616).
Two types of drugs are used to treat (BPH): 5-alpha-reductase inhibitors and alpha-1-adrenergic blockers. Research suggests that these drugs improve BPH symptoms in 30 to 60% of men. However, it is not yet possible to predict who will respond to medication or which drug will work best for a particular person.
For men with moderate to severe lower urinary tract symptoms and BPH who are at high risk for BPH progression, using two different types of drugs may be the most effective approach.
In an ongoing study known as CombAT (Combination of Avodart and Tamsulosin), researchers compared the effectiveness of the 5-alpha reductase inhibitor dutasteride (Avodart) and the alpha-blocker tamsulosin (Flomax) with the use of either drug alone in reducing symptoms and prostate size.
Study participants were age 50 or older, had moderate to severe BPH symptoms, and were at risk for disease progression as indicated by a prostate volume of at least 30 mL and/or a prostate-specific antigen (PSA) level of 1.5 ng/mL or greater. The nearly 5,000 men were assigned to receive either 0.5 mg of dutasteride, 0.4 mg of tamsulosin, or a combination of the two drugs for four years.
At two years, men taking combination therapy had significantly greater BPH symptom improvements than men taking either Avodart or Flomax alone. Combination therapy was also better than Flomax, but not Avodart, in reducing prostate volume.
