In a nutshell
This study investigated drug combinations with silodosin (Rapaflo) to treat overactive bladder (OAB) in men with benign prostatic hyperplasia (BPH).
They found that fesoterodine (Toviaz) was more effective than mirabegron (Mirbetriq) as add-ons to silodosin in these patients.
Some background
Benign prostatic hyperplasia (BPH) is the medical term for an enlarged prostate gland. BPH is common in aging men. It is also associated with lower urinary tract symptoms (LUTS). LUTS such as dribbling of urine can have a negative impact on quality of life. Some patients with BPH will experience overactive bladder (OAB). This involves a sudden urge to urinate. To manage OAB, patients with BPH are usually prescribed a drug to block receptors in the prostate. Silodosin works by relaxing smooth muscle in the neck of the bladder and the prostate. This improves urine flow.
Some patients also have issues with bladder capacity. Medication that increases the bladder capacity may improve OAB symptoms. Mirabegron and fesoterodine are drugs that cause relaxation of the bladder muscle and increase bladder capacity. It is unclear if mirabegron or fesoterodine is effective in combination with silodosin for treating OAB in men with BPH.
Methods & findings
This study included 102 patients with BPH and OAB. Patients were randomly assigned to treatment with either fesoterodine or mirabegron in addition to silodosin. The trial lasted 12 weeks. Urinary symptoms were evaluated before and after treatment.
OAB symptoms improved significantly in both groups. Fesoterodine treatment led to a greater improvement than mirabegron. Urine storage was improved in both groups. Fesoterodine-treated patients had greater improvements. Voiding frequency was similar in both groups at 12 weeks. The residual urine in the bladder after urination was higher in fesoterodine patients. Quality of life was significantly higher in fesoterodine-treated patients.
The bottom line
The authors concluded that fesoterodine was more effective than mirabegron as an add-on to silodosin in patients with OAB and BPH.
The fine print
This was a relatively short study. More investigation is needed into the long-term effects of these drug combinations.
What’s next?
If you have any concerns regarding OAB management, please consult with your doctor.
Published By :
Neurourology and urodynamics
Date :
Feb 19, 2019
