Efficacy of Alfuzosin in Male Patients with Moderate Lower Urinary Tract Symptoms: Is Metabolic Syndrome a Factor Affecting the Outcome?
5 January 2019
Purpose: The present study was designed to compare the efficacy of alfuzosin therapy as an alpha-blocker in metabolic syndrome (MetS) and non-MetS patients with moderate lower urinary tract symptoms (LUTS).
Material and Methods: This prospective study included male patients with obstructive voiding and had a moderate LUTS according to International Prostate Symptom Score (IPSS). Patients were divided into two groups: MetS and Non-MetS. Following the measurement of uroflowmetric parameters (maximum flow rate [Qmax], post-void residual volume [PVR], urine volume) and the determination of IPSS scores, the patients were initiated on alfuzosin 10 mg once daily for a period of 12 weeks. At the end of the therapy, treatment outcomes were determined based on uroflowmetric parameters and IPSS scores.
Results: 301 patients were included in the study (MetS: 160, non-MetS: 141). Pre-treatment uroflowmetric measurements and IPSS scores were similar in both groups. After the therapy, the median Qmax level increased from 12.80 (10.62-14.82) ml/s to 14.55 (12.00-16.60) ml/s in the MetS group and from 12.60 (8.60-14.60) ml/s to 15.70 (13.20-17.20) ml/s in the non-MetS group (p<0.001 for both). Similar statistically significant changes were valid for PVR and IPSS. Post-treatment Qmax, PVR values and IPSS scores were higher in the non-MetS patients compared to MetS patients.
Conclusion: Although the non-MetS patients had greater benefit from the alfuzosin therapy compared to the MetS patients, alfuzosin is an effective alpha-blocker in the treatment of MetS patients with moderate LUTS. Based on these findings, it is tempting to consider that MetS might be a negative factor for benign prostate hyperplasia treatment.
- Metabolic syndrome
De Nunzio C, Albisinni S, Gacci M. The role of inflammation in the progression of benign prostatic hyperplasia. Curr Bladder Dysfunct Rep. 2013;8: 142-9.
Platz EA, Joshu CE, Mondul AM, Peskoe SB, Willett WC, Giovannucci E. Incidence and progression of lower urinary tract symptoms in a large prospective cohort of United States men. J Urol. 2012;188: 496-501.
Chughtai B, Forde JC, Thomas DD, et al. Benign prostatic hyperplasia. Nat Rev Dis Primers. 2016; 2:16031
Pashootan P, Ploussard G, Cocaul A, de Gouvello A, Desgrandchamps F. Association between metabolic syndrome and severity of lower urinary tract symptoms (LUTS): an observational study in a 4666 European men cohort. BJU Int. 2015;116: 124-30.
Ngai HY, Yuen KS, Ng CM, Cheng CH, Chu SP. Metabolic syndrome and benign prostatic hyperplasia: An update. Asian J Urol. 2017;4:164-73.
Gacci M, Sebastianelli A, Salvi M, et al. Benign prostatic enlargement can be influenced by metabolic profile: results of a multicenter prospective study. BMC Urol. 2017;17: 22.
Doğan Y, Uruç F, Aras B, et al. The relationships between metabolic syndrome, erectile dysfunction and lower urinary tract symptoms associated with benign prostatic hyperplasia. Turk J Urol. 2015;41: 7-12.
Zorba OÜ, Uzun H, Akça G, Yazar S. The Effect of Different Metabolic Syndrome: Definitions on the Relationship Between Metabolic Syndrome and LUTS in Men With Benign Prostatic Enlargement. Am J Mens Health. 2017;11: 158-63.
Alberti KG, Zimmet P, Shaw J; IDF Epidemiology Task Force Consensus Group. The metabolic syndrome--a new worldwide definition. Lancet. 2005;366: 1059-62.
Lee YC, Liu CC, Juan YS, et al. The impact of metabolic syndrome on the responsiveness to α1-blocker in men with BPH/LUTS. Int J Clin Pract. 2013;67: 356-62.
Cyrus A, Kabir A, Goodarzi D, et al. Impact of metabolic syndrome on response to medical treatment of benign prostatic hyperplasia. Korean J Urol. 2014;55: 814-20.
Yoon H, Yoon HS, Lee YS, Cho ST, Han DH. Effect of Tamsulosin in Lower Urinary Tract Symptom Patients with Metabolic Syndrome. Urology. 2016;88: 135-42.
Altin S, Ozan T, Ilhan S, Ilhan N, Onur R. Metabolic syndrome does not impair the response to alfuzosin treatment in men with lower urinary tract symptoms: a double-blind, randomized, placebo-controlled study. Turk J Urol. 2015;41: 125-31.
Fu Y, Zhou Z, Yang B, Zhang K, He L, Zhang X. The Relationship between the Clinical Progression of Benign Prostatic Hyperplasia and Metabolic Syndrome: A Prospective Study. Urol Int. 2016;97: 330-5.
Gacci M, Corona G, Vignozzi L, et al. Metabolic syndrome and benign prostatic enlargement: a systematic review and meta-analysis. BJU Int. 2015;115: 24-31.
Zhang J, Li X, Yang B, Wu C, Fan Y, Li H. Alpha-blockers with or without phosphodiesterase type 5 inhibitor for treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia: a systematic review and meta-analysis. World J Urol. 2019;37: 143-53.
Debruyne FM, Jardin A, Colloi D, et al. Sustained-release alfuzosin, finasteride and the combination of both in the treatment of benign prostatic hyperplasia. European ALFIN Study Group. Eur Urol 1998; 34:169–75.
Yuan JQ, Mao C, Wong SY, et al. Comparative Effectiveness and Safety of Monodrug Therapies for Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia: A Network Meta-analysis. Medicine (Baltimore). 2015;94:e974.
Yoon S, Choi JH, Lee SH, et al. Efficacy of Long-Term Daily Dosage of Alfuzosin 10 mg upon Sexual Function of Benign Prostatic Hypertrophy Patients: Two-Year Prospective Observational Study. World J Mens Health. 2014;32:133-8.
Singal R, Bhatia G, Mittal A, Singal S, Zaman M. To compare the efficacy of tamsulosin and alfuzosin as medical expulsive therapy for ureteric stones. Avicenna J Med. 2017;7: 115-20.
Zhang LT, Lee SW, Park K, et al. Multicenter, prospective, comparative cohort study evaluating the efficacy and safety of alfuzosin 10 mg with regard to blood pressure in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia with or without antihypertensive medications. Clin Interv Aging. 2015;10: 277-86.
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