The latest in clinical trial results of 5-alpha reductase inhibitors in combination regimens for benign prostatic hyperplasia


Kapriniotis K., Manolitsis I., Juliebo-Jones P., Pietropaolo A., Tsaturyan A., TONYALI Ş., ...Daha Fazla

Expert Opinion on Pharmacotherapy, cilt.26, sa.3, ss.301-311, 2025 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 26 Sayı: 3
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1080/14656566.2025.2453586
  • Dergi Adı: Expert Opinion on Pharmacotherapy
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.301-311
  • Anahtar Kelimeler: 5-ARI, anticholinergic, BPH, male LUTS, PDEI, α-blocker, β-3 agonist
  • İstanbul Üniversitesi Adresli: Evet

Özet

Introduction: BPH/male LUTS is a prevalent condition in the aging male population with multifactorial pathophysiology. Pharmacotherapy remains the cornerstone of treatment in patients who fail conservative treatment. 5-α-Reductase inhibitors (5-ARIs) are the only class of medication shown to reduce the risk of acute retention and BPH-related surgery and, thus, are commonly used along with other “short acting” medications in combination treatments. Areas covered: Combination treatments with α-blockers and 5-ARIs have been investigated extensively in high quality trials that prove the long-term efficacy of such treatments with acceptable rates of side effects. Combination treatments involving 5-ARIs and other classes of medications (anticholinergics, b3 agonists, PDEI) have been shown to be beneficial in the short term and but studies with longer follow-up periods are required to fully establish their role. Expert opinion: A-blocker/5-ARI combination treatment is a reasonable approach for patients with male LUTS/BPH who are at increased risk of disease progression or have incomplete response to monotherapies. Other combination treatments with 5-ARIs and PDEI or anticholinergics/β-3 agonists can be tried based on predominant symptoms or side effect profile, but patients should be informed about the lack of long-term data.