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- Title
Comparison of the clinical effect of dutasteride therapy for benign prostatic hyperplasia when initiated at different time points: A multicentre, observational, retrospective chart review study.
- Authors
Shima, Yukiko; Kawano, Yoshiaki; Kobayashi, Akihiro; Yamanishi, Tomonori; Takeda, Hirokazu; Palacios‐Moreno, Juan Manuel; Yamada, Masahiro; Masumori, Naoya; Fukuta, F; Nanri, M; Nishino, Y; Sagiyama, K; Tsujimoto, Y; Arai, Y; Ohoka, H; Yamaguchi, T; Nagao, K; Noma, Y; Suzuki, K; Okamoto, T
- Abstract
<bold>Aim: </bold>To evaluate the effects of early (≤6 months after starting any medical treatment [baseline] for benign prostatic hyperplasia [BPH]), intermediate (between >6 months and 2 years from baseline) and late (2 years after baseline) initiation of add-on dutasteride therapy on the incidence of acute urinary retention (AUR) and BPH-related surgery in Japanese patients with moderate-to-severe BPH.<bold>Methods: </bold>This multicentre, observational, retrospective chart review study used anonymised data from Japanese medical records. Eligible patients (≥50 years) were followed from baseline until first AUR, BPH-related surgery or Year 4.<bold>Results: </bold>Overall, 1206 patients were included (early initiation: n = 793; intermediate: n = 233; late: n = 180). Early dutasteride initiation was not superior to late initiation in reducing the risk of first AUR or BPH-related surgery from baseline (hazard ratio [HR] 0.733; 95% confidence interval [CI] 0.468-1.150) but was superior in reducing the risk of first AUR alone (HR 3.449; 95% CI 1.796-6.623). One year after initiation, the cumulative incidence of first AUR rose rapidly in the late vs early and intermediate initiation groups. Incidences of all parameters (first AUR/BPH-related surgery, first AUR alone and BPH-related surgery alone) in patients undergoing BPH-related surgery in low incidence sites (ie clinical sites with ≤ 16% incidence of first AUR or BPH-related surgery) were significantly lower in the early vs late initiation groups.<bold>Conclusion: </bold>Early dutasteride initiation reduced the risk of AUR in a Japanese real-world setting. A randomised controlled trial is warranted to evaluate the benefit of early initiation in preventing BPH-related surgery in Japanese patients.
- Publication
International Journal of Clinical Practice, 2019, Vol 73, Issue 12, pN.PAG
- ISSN
1368-5031
- Publication type
journal article
- DOI
10.1111/ijcp.13418