Tanuma Yasushi, Tanaka Yoshinori, Takeyama Ko, Okamoto Tomoshi
Department of Urology, Hokkaido Social Welfare Association Hakodate Hospital, Hakodate, Japan.
Department of Urology, Hokkaido Prefectural Esashi Hospital, Esashi, Japan.
Urol Ann. 2017 Jul-Sep;9(3):261-267. doi: 10.4103/UA.UA_23_17.
We evaluated the predictive factors which affect the efficacy of naftopidil 50 mg/day therapy and dose increase therapy to administration of 75 mg/day after an initial dose of 50 mg/day.
A total of 92 patients with male lower urinary tract symptoms/benign prostatic hyperplasia were administrated naftopidil 50 mg/day for 4 weeks (50 mg therapy). At week 4, the patients were divided into an effective and an ineffective group (Group E and Group I, respectively). For further 4 weeks, the dosage of naftopidil was increased to 75 mg/day in all patients. At week 8, the patients of Group E and Group I were divided into an effective and an ineffective group (Group EE, Group EI, Group IE, and Group II, respectively).
Postvoid residual (PVR) urine volume at baseline was a predictive factor for efficacy of 50 mg therapy. In Group E, change in International Prostate Symptom Score storage symptoms subscore from baseline to week 4 was a predictive factor for efficacy of this dose increase therapy. In Group I, change in maximum flow rate from baseline to week 4 was a predictive factor for efficacy of this dose increase therapy.
The short term of naftopidil 50 mg therapy was ineffective for the patients who had large PVR. The predictive factor of this dose increase therapy might be a dynamic variable in 50 mg/day of dose period, but not a baseline variable at the time of 75 mg/day dosage starts.
我们评估了影响萘哌地尔50毫克/天治疗疗效以及在初始剂量50毫克/天后增加至75毫克/天剂量治疗疗效的预测因素。
总共92例男性下尿路症状/良性前列腺增生患者接受萘哌地尔50毫克/天治疗4周(50毫克治疗组)。在第4周时,将患者分为有效组和无效组(分别为E组和I组)。在接下来的4周里,所有患者的萘哌地尔剂量增加至75毫克/天。在第8周时,E组和I组的患者再分别分为有效组和无效组(分别为EE组、EI组、IE组和II组)。
基线时的残余尿量(PVR)是50毫克治疗疗效的预测因素。在E组中,从基线到第4周国际前列腺症状评分储尿症状子评分的变化是该剂量增加治疗疗效的预测因素。在I组中,从基线到第4周最大尿流率的变化是该剂量增加治疗疗效的预测因素。
对于残余尿量较大的患者,萘哌地尔50毫克的短期治疗无效。该剂量增加治疗的预测因素可能是50毫克/天剂量期的动态变量,而非开始75毫克/天剂量时的基线变量。