This study evaluated the effectiveness of dutasteride (Avodart) for the treatment of nocturia among men with benign prostatic hyperplasia (BPH).

The authors concluded that dutasteride shows some benefit at reducing episodes of nocturia.

Nocturia refers to a frequent need to wake up at night and pass urine. Nocturia is one of the most frequently reported and bothersome symptoms among men with BPH. Dutasteride (a five-alpha reductase inhibitor) is commonly used to treat urinary symptoms associated with BPH, and has been found to decrease prostate size. Recent studies are suggesting that dutasteride can also help reduce episodes of nocturia. However, conclusive evidence regarding its effectiveness is still lacking.

This study included three separate randomized trials, including a combined total of 4,321 men with symptoms suggestive of BPH. Men were received treatment with either dutasteride or with placebo (a control drug with no active effect). Results from the three trials were pooled into a single analysis. Treatment outcome was followed for an average of two years.

Before treatment, men reported an average of 2.4 episodes of nocturia per night. Only 3% of men were completely free of nocturia. Treatment with dutasteride reduced nocturia significantly more than placebo. After two years of treatment, the average number of nocturia episodes (or voids) per night was virtually unchanged for men receiving placebo (2.3 voids per night), but was reduced to an average of 2.1 voids per night for men receiving dutasteride.

Among men with severe nocturia (2 or more voids per night), about half (48%) reported a marked improvement after two years of treatment with dutasteride (compared to 40% of men receiving placebo). Also, significantly more men who were treated with dutasteride reported less than 2 voids per night at the end of the study follow-up (26%), relative to placebo (19%).

The researchers concluded that dutasteride shows some benefit at reducing episodes of nocturia among men with BPH.

No information was provided in this study regarding possible side-effects associated with dutasteride. Further trails specifically designed to measure nocturia are needed to investigate the optimal management of night-time symptoms.