High blood pressure. Causes, symptoms, treatments

Application of derivative spectrophotometry for simultaneous determination of quinapril and hydrochlorothiazide in the combination tablets.

2017-05-30

The aim of the study is to present the effects of BPH pharmacological treatment on the occurrence of sexually adverse effects in men: changes in sexual desire, erectile, ejaculatory and the orgasmic function.

The Qmax and the symptoms improvement found in all the studies has a moderate clinical relevance. MTOPS study shows that BPH progression has a low incidence that can be highly reduced by means of combination therapy.

Assessment of the effectiveness of a comprehensive treatment protocol for LUTS in primary care.

To critique the US Department of Health and Human Services Public Health Service, Agency for Health Care Policy and Research, Clinical Practice Guideline on Benign Prostatic Hyperplasia: Diagnosis and Treatment; and to provide an update on management and treatment of benign prostatic hyperplasia (BPH) since the Guideline was published.

A Markov model was developed to estimate the clinical progression that a cohort of 1000 men would undergo and the care they would receive over 4- and 15.5-year periods. Transitions between health states [BPH symptoms, improvement in symptoms, acute urinary retention (AUR), TURP, prostate cancer and death] were estimated from the published literature and knowledge of the Norwegian healthcare system. Sensitivity analyses were conducted of indirect costs, discount rates, the costs and probabilities of AUR and TURP and the probability of symptom improvement.

Occurrences of AUR and surgical intervention were examined by treatment group in a pooled series of 4222 men with moderately symptomatic BPH.

Epristeride is a transition-state, noncompetitive steroid 5-alpha-reductase inhibitor under development by SmithKline Beecham for the treatment of benign prostatic hyperplasia and acne. Phase III trials for prostatic hypertrophy with an oral formulation, have been initiated in the UK, the US and Japan [188478], [219166]. In healthy male volunteers, epristeride caused a reduction in serum dihydrotestosterone levels but serum testos-terone levels remained stable. In animal studies, it showed a similar potency to finasteride for the inhibition of 5-alpha-reductase [164200]. Epristeride is licensed to Ono which has exclusive rights in Japan, South Korea and Taiwan. Recordati has co-marketing rights for epristeride [162547], [162519]. Analysts at Yamaichi estimate that epristeride will be launched in Japan between 1999 and 2000 and peak annual sales have been predicted to be over ten billion Yen [216018].

Voiding symptoms improved in all groups receiving therapy. The side effects on the sexual function in all these groups include significant disorders of ejaculation and the orgasmic function. Ejaculation disorders: tamsulosin (-4.38 ± 2.55; p < 0.001), combined therapy (-3.89± 2.84) and finasteride (-1.49 ± 2.52). Orgasmic function disorders: tamsulosin (-1.03 ± 1.94), combined therapy (-0.76 ± 2.07) and finasteride (-0.54 ± 1.68). Complete absence of ejaculation was experienced by 23% of patients on combined therapy, 15% on tamsulosin and 5% on finasteride.

A subgroup of 431 patients was analysed from a randomized, multicentre, double-blind clinical trial involving 543 patients with the early stages of BPH. Patients received a fixed combination of extracts of saw palmetto fruit (Serenoa repens) and nettle root (Urtica dioica) (PRO 160/120) or the synthetic 5alpha-reductase inhibitor finasteride. The patients assessed had valid ultrasonographic measurements and baseline prostate volumes of either </= 40 mL or > 40 mL. All 516 patients were included in the safety analysis. The results of the original trial showed equivalent efficacy for both treatments.

This study assessed the preferences of urologists in the diagnosis and treatment of BPH, which will serve as an important reference for updating and improving China's current BPH clinical practice guideline.

A retrospective analysis of administrative claims data from 2003-2013 was conducted to compare outcomes between patients with claims for early combination therapy with dutasteride + AB and patients with claims for early finasteride + AB. The study population included males aged older than 50 years with at least 1 medical claim with a diagnosis of BPH and pharmacy dispensing for AB and 5ARI therapies. Outcomes included acute urinary retention (AUR), prostate-related surgery, clinical progression, medical and pharmacy costs, and health care resource utilization. Inverse probability of treatment (IPT) weighted Cox proportional hazards, linear, and Poisson regression models were used to assess the association between outcomes and early combination therapy as appropriate.

The initial median PSA level was 19.8 ng/mL: at 3, 6 and 12 months the median PSA had fallen to 1.2, 0.85 and 0.8 ng/mL, respectively. In four patients followed for 2 years, the anti-neoplastic effects were sustained. Patients with initially palpable disease had regression, as assessed by a digital rectal examination. Side-effects included gynaecomastia (five patients), mildly elevated hepatic transaminases (two) and diarrhoea (one). Most men maintained their previous sexual function.