Alpha-Blocker Treatment Response in Men With Lower Urinary Tract Symptoms Based on Sympathetic Activity: Prospective, Multicenter, Open-Labeled, Observational Study
0
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Purpose: In this study, we compared the treatment outcomes for an α-blocker between 2 groups of men, one with high sympathetic activity (HSA) and another with low sympathetic activity (LSA) or normal sympathetic activity. Methods: A total of 159 men (≥50 years of age) with lower urinary tract symptoms resulting from benign prostatic hyperplasia were analyzed. We assigned patients to groups according to their sympathetic activity, which was evaluated by heart rate variability measurements. HSA was defined as a low frequency/high frequency ratio greater than 1.6. All patients received 10 mg of alfuzosin once a day for 12 weeks. The primary end point was a change in the total International Prostate Symptom Score (IPSS) at 12 weeks from baseline. Results: Sixty-seven men were assigned to the HSA group and 92 men were assigned to the LSA group. The baseline characteristics were not significantly different between the 2 groups, and the response to alfuzosin was good in both groups. The mean total IPSS change was not different between the groups. Both groups were not significantly different with respect to the changes in maximal flow rate, IPSS voiding or storage symptom subscores, quality of life, and rates of adverse drug events. The HSA group showed a similar willingness to continue treatment compared to the LSA group, although their treatment satisfaction rating was lower. Conclusions: The therapeutic effects of alfuzosin did not differ in regards to the differences in sympathetic activity, but treatment satisfaction ratings were lower in the HSA group.
Abstract
Purpose: In this study, we compared the treatment outcomes for an α-blocker between 2 groups of men, one with high sympathetic activity (HSA) and another with low sympathetic activity (LSA) or normal sympathetic activity. Methods: A total of 159 men (≥50 years of age) with lower urinary tract symptoms resulting from benign prostatic hyperplasia were analyzed. We assigned patients to groups according to their sympathetic activity, which was evaluated by heart rate variability measurements. HSA was defined as a low frequency/high frequency ratio greater than 1.6. All patients received 10 mg of alfuzosin once a day for 12 weeks. The primary end point was a change in the total International Prostate Symptom Score (IPSS) at 12 weeks from baseline. Results: Sixty-seven men were assigned to the HSA group and 92 men were assigned to the LSA group. The baseline characteristics were not significantly different between the 2 groups, and the response to alfuzosin was good in both groups. The mean total IPSS change was not different between the groups. Both groups were not significantly different with respect to the changes in maximal flow rate, IPSS voiding or storage symptom subscores, quality of life, and rates of adverse drug events. The HSA group showed a similar willingness to continue treatment compared to the LSA group, although their treatment satisfaction rating was lower. Conclusions: The therapeutic effects of alfuzosin did not differ in regards to the differences in sympathetic activity, but treatment satisfaction ratings were lower in the HSA group.
참고문헌 (24)
- 최세영, "Impact of Changing Trends in Medical Therapy on Surgery for Benign Prostatic Hyperplasia Over Two Decades", Investigative and Clinical Urology, 53(1), pp.23~28 (2012), 대한비뇨기과학회
- Madersbacher S, "EAU 2004 guidelines on assessment, therapy and follow-up of men with lower urinary tract symptoms suggestive of benign prostatic obstruction (BPH guidelines)", Eur Urol, 46, pp.547~554 (2004)
- Ventura S, "Novel drug targets for the pharmacotherapy of benign prostatic hyperplasia (BPH)", Br J Pharmacol, 163, pp.891~907 (2011)
- Roehrborn CG, "Alpha1-adrenergic receptors and their inhibitors in lower urinary tract symptoms and benign prostatic hyperplasia", J Urol, 171, pp.1029~1035 (2004)
- Miano R, "Treatment options for benign prostatic hyperplasia in older men", Med Sci Monit, 14, pp.RA94~RA102 (2008)
- Hammarsten J, "Clinical, anthropometric, metabolic and insulin profile of men with fast annual growth rates of benign prostatic hyperplasia", Blood Press, 8, pp.29~36 (1999)
- McVary KT, "Autonomic nervous system overactivity in men with lower urinary tract symptoms secondary to benign prostatic hyperplasia", J Urol, 174(4Pt1), pp.1327~1433 (2005)
- Choi JB, "Characteristics of autonomic nervous system activity in men with lower urinary tract symptoms (LUTS): analysis of heart rate variability in men with LUTS", Urology, 75, pp.138~142 (2010)
- Low PA, "Testing the autonomic nervous system", Semin Neurol, 23, pp.407~421 (2003)
- "Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology", Circulation, 93, pp.1043~1065 (1996)
- Pleil AM, "The validation of patient-rated global assessments of treatment benefit, satisfaction, and willingness to continue: the BSW", Value Health, 8(Suppl 1), pp.S25~S34 (2005)
- Hahn DW, "Korean adaptation of Spielberger’s STAI (K-STAI)", Korean J Health Psychol, 1, pp.1~14 (1996)
- Eckhardt MD, "Symptoms and quality of life versus age, prostate volume, and urodynamic parameters in 565 strictly selected men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia", Urology, 57, pp.695~700 (2001)
- Shapiro E, "The response to alpha blockade in benign prostatic hyperplasia is related to the percent area density of prostate smooth muscle", Prostate, 21, pp.297~307 (1992)
- Mazur DJ, "Influences of neuroregulatory factors on the development of lower urinary tract symptoms", benign prostatic hyperplasia and erectile dysfunction in aging men, 2012, pp.39, 77~88
- McVary KT, "Growth of the rat prostate gland is facilitated by the autonomic nervous system", Biol Reprod, 51, pp.99~107 (1994)
- Meigs JB, "Risk factors for clinical benign prostatic hyperplasia in a community-based population of healthy aging men", J Clin Epidemiol, 54, pp.935~944 (2001)
- Hon EH, "Electronic evaluation of the fetal heart rate. VIII. Patterns preceding fetal death, further observations", Am J Obstet Gynecol, 87, pp.814~826 (1963)
- 이지용, "Heart Rate Variability in Men with Erectile dysfunction", International Neurourology Journal, 15(2), pp.87~91 (2011), 대한배뇨장애요실금학회
- Cho DS, "Heart rate variability in assessment of autonomic dysfunction in patients with chronic prostatitis", chronic pelvic pain syndrome, 2011, pp.78, 1369~1372
- 김준철, "Alteration of Autonomic Function in Female Urinary Incontinence", International Neurourology Journal, 14(4), pp.232~237 (2010), 대한배뇨장애요실금학회
- Roehrborn CG, "Safety and efficacy of alfuzosin 10 mg once-daily in the treatment of lower urinary tract symptoms and clinical benign prostatic hyperplasia: a pooled analysis of three double-blind, placebo-controlled studies", BJU Int, 92, pp.257~261 (2003)
- Kenny BA, "Evaluation of the pharmacological selectivity profile of alpha 1 adrenoceptor antagonists at prostatic alpha 1 adrenoceptors: binding, functional and in vivo studies", Br J Pharmacol, 118, pp.871~878 (1996)
- Forray C, "The alpha 1-adrenergic receptor that mediates smooth muscle contraction in human prostate has the pharmacological properties of the cloned human alpha 1c subtype", Mol Pharmacol, 45, pp.703~708 (1994)
