Silodosin as second‐line α‐blocker monotherapy in patients with benign prostatic hyperplasia: A prospective observational study

• Published in: International journal of urology 2018-10, Vol.25 (10), p.849-854
• Main Authors: Ichihara, Koji, Masumori, Naoya, Iwasawa, Akihiko, Taguchi, Keisuke, Yamaguchi, Yasuhiro, Nishimura, Masahiro, Sasamura, Hiroto, Suzuki, Nobukazu, Haga, Kazunori, Miyao, Noriomi, Hirose, Takaoki
• Format: Article
• Language: English
• Subjects: Adrenergic alpha-1 Receptor Antagonists - therapeutic use; Aged; Benign; benign prostatic hyperplasia; Humans; Hyperplasia; Indoles - therapeutic use; Lower Urinary Tract Symptoms - diagnosis; Lower Urinary Tract Symptoms - drug therapy; Lower Urinary Tract Symptoms - etiology; Male; medication; Naphthalenes - therapeutic use; Observational studies; Patients; Piperazines - therapeutic use; Prospective Studies; Prostate; Prostatic Hyperplasia - complications; Prostatic Hyperplasia - drug therapy; Quality of Life; Severity of Illness Index; silodosin; Tamsulosin - therapeutic use; Treatment Outcome; Urinary tract; Urogenital system; α1 blocker
• ISSN: 0919-8172; 1442-2042
• DOI: 10.1111/iju.13757

Objective To assess the efficacy of silodosin as second‐line α‐blocker monotherapy in patients with lower urinary tract symptoms as a result of benign prostatic hyperplasia. Methods Men who were given an α‐blocker other than silodosin for ≥8 weeks, aged ≥50 years, had a total International Prostate Symptom Score ≥13 and quality of life index ≥4 were enrolled. After treatment with 8 mg/day silodosin for 8 weeks, symptoms and treatment satisfaction were assessed. If the patients still complained and hoped for readministration of the first‐line α‐blocker, the previous medication was administered again for 8 weeks in the case of persisting symptoms, and efficacy was again evaluated. Results A total of 73 patients were enrolled and analyzed at 8 weeks. Silodosin administration significantly improved the International Prostate Symptom Score and Overactive Bladder Symptom Score. The quality of life index was improved by at least 1 point in 49.3% patients, and its mean change was significantly greater in the group with previous naftopidil treatment than in those with tamsulosin. A total of 59 patients hoped to continue silodosin, and 13 requested administration of the first‐line α‐blocker. Previously taking naftopidil and having a shorter duration of prior α‐blocker treatment at baseline were associated with silodosin continuation. Although prior α‐blocker readministration in the 13 patients did not show significant efficacy, six preferred to continue the previous α‐blocker. Conclusions Silodosin represents an effective second‐line α‐blocker monotherapy, even in those who still have moderate lower urinary tract symptoms.