- Combination therapy with tamsulosin (Flomax) and dutasteride (Avodart) is more effective than tamsulosin alone for reducing progression of benign prostatic hyperplasia (BPH) symptoms and acute urinary retention.
Why this matters
- This analysis could inform decisions for treating BPH.
- Researchers analyzed 5 randomized controlled trials comparing BPH treatment with a combination of tamsulosin and dutasteride vs tamsulosin alone (N=4348).
- Funding: None.
- Combination therapy significantly reduced risk for (ORs, 95% CIs):
- BPH symptom progression: 0.56 (0.46-0.67; P<.00001>
- Acute urinary retention: 0.61 (0.38-0.98; P=.04).
- However, patients undergoing combination therapy also experienced more adverse sexual effects, including (ORs; 95% CIs):
- erectile dysfunction: 2.24 (1.73-2.92; P<.00001>
- ejaculation disorder: 3.37 (1.97-5.79; P<.0001>
- retrograde ejaculation: 2.30 (1.08-4.93; P=.03);
- decreased libido: 2.25 (1.53-3.31; P<.0001>
- loss of libido: 3.38 (1.94-5.88; P<.0001>
- The number of randomized controlled trials available for analysis was small.
- Trial results did not include data on long-term efficacy and tolerance of combination therapy.