World Journal of
Pharmaceutical and Life Sciences

MEDICAL TREATMENT OF SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA: A COMPARISON BETWEEN COMBINED DUTASTERIDE AND TAMSULOSIN MONOTHERAPY

Md. Shamim Hossain*, Morshed Nasir, ABM Mahbubur Rahman, Towhid Belal, Tanvir Ahmed Chowdhury and Md. Mizanur Rahman

ABSTRACT

Benign prostatic hyperplasia is a common problem in elderly male. The number of symptomatic benign prostatic hyperplasia is also increasing with increased life expectancy. This ultimately results in complications requiring surgical treatment. However there is increasing interest in the use of drug therapy rather than surgical intervention, especially in patients with mild to moderate symptoms and who are unable or unwilling to undergo surgery. The case control study was done on 145 patients with symptomatic benign prostatic hyperplasia to evaluate the efficacy of combination therapy of Dutasteride and Tamsulosin in comparison with Tamsulosin monotherapy in term of relief of symptoms and increase in urinary flow rate. Among them in group-A comprising 46 cases, group-B 47 cases and group-C 45 cases. During study period 2 patients from group-A, 5 patients from group-B and 3 patients from group-C did not attend the follow up schedule. Ultimately 42 cases from each group were compared. Placebo was given to each cases of Group-A, Tamsulosin 0.4 mg to Group-B and combination of Tamsulosin 0.4 mg + Dutasteride 0.5mg to Group-C. a significant improvement of IPSS was found after 12 months of treatment with Tamsulosin (group-B) and combination therapy (Tamsulosin+Finasteride) (group-C). This changes were tested using paired student 't' test. The change was found significant (p= <0.001). Mean change of peak urine flow rate in group-A was 0.29±1.46, in group-B was 5.00±1.25 and in group-C was 5.50±1.70. Hence a significant improvement of peak urine flow rate was found after 12 months treatment with 0.4 mg of Tamsulosin (group-B) and with combination (Tamsulosin + Dutaasteride). Significant decreased of post voidal urine volume and changes of prostate volume was found after 12 months of treatment. From the present study it can be concluded that the best option of treatment for clinically benign prostate hyperplasia with mild to moderate symptoms is combination of 0.4 mg Tamsulosin and 0.5mg Dutasteride once daily. This study inferred that combination therapy is more effective in the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia leading to rapid improvement of symptoms by Tamsulosin and decreased disease progression and sustained improvement by Dutasteride.

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