Low-dose tamsulosin relieves lower urinary tract symptoms in Asian men

By Will Boggs MD

NEW YORK (Reuters Health) - Low-dose tamsulosin is effective for treating lower urinary tract symptoms (LUTS) in Asian men with benign prostatic hyperplasia (BPH), according to a new meta-analysis.

"The crucial point of our article is to prove the effectiveness and safety of low-dose tamsulosin, which could affect the widened indication of low-dose tamsulosin in both Asian and Western countries," Dr. Jae Heon Kim from Soonchunhyang University College of Medicine in Seoul, Korea, told Reuters Health by email. "This could affect the current trend of 0.4 mg tamsulosin as a standard initial treatment strategy in Western countries."

Many studies have demonstrated the effectiveness of tamsulosin daily doses ranging from 0.2 to 0.8 mg in men with symptomatic BPH, Dr. Kim and colleagues write in Current Medical Research & Opinion, online October 28.

While low-dose tamsulosin (0.2 mg) is widely used in Asian men, who have a lower body mass index, it has been less popular than the 0.4 mg dose or other types of alpha-blockers, they add.

In a meta-analysis including 14 randomized controlled trials and more than 2,100 participants, the researchers found treatment with low-dose tamsulosin led to significant improvements in International Prostate Symptom Score (IPSS), quality of life measures, maximum urinary flow rates, and post-void residuals.

Overall, about 72.9% of men treated with low-dose tamsulosin experienced significant clinical improvement, the researchers say. Results were similar in studies from China, Japan and Korea.

In the trials that reported adverse events, tamsulosin was generally well tolerated and had lower rates of adverse events compared with terazosin.

"Low doses of other alpha blockers have been scarcely investigated," Dr. Kim said. "About the issue whether low-dose tamsulosin has the same efficacy as other standard-dosed alpha blockers, another meta-analysis has been done and is under review. (It) showed that low-dose tamsulosin had a similar efficacy as other alpha blockers."

"The prevalence of lower urinary tract symptoms is high in older populations who are more vulnerable and also have polypharmacy," Dr. Kim added. "The effort of lowering dose if it is reasonable should be maintained. To date, too many reports emphasize only increasing the dose."

SOURCE: http://bit.ly/1yqRqJO

Current Med Res Opinion 2014.

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