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评价度他雄胺/坦索罗辛联合治疗对良性前列腺增生(BPH)继发下尿路症状(LUTS)且有性生活的男性患者性欲的影响:一项前瞻性随机安慰剂对照研究的事后分析。

Evaluation of the impact of dutasteride/tamsulosin combination therapy on libido in sexually active men with lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH): A post hoc analysis of a prospective randomised placebo-controlled study.

机构信息

HealthCore/New England Research Institutes, Watertown, Massachusetts.

Department of Urology, UT Southwestern Medical Center, Dallas, Texas.

出版信息

Int J Clin Pract. 2019 Sep;73(9):1-9. doi: 10.1111/ijcp.13282. Epub 2018 Nov 5.

DOI:10.1111/ijcp.13282
PMID:30317693
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6767409/
Abstract

AIMS

Five-α reductase inhibitor (5ARI) therapy has been associated with sexual dysfunction in some patients. This study assessed the impact of a fixed-dose combination of the 5ARI dutasteride 0.5 mg and the α -adrenoceptor antagonist tamsulosin 0.4 mg (DUT-TAM FDC) on Men's Sexual Health Questionnaire (MSHQ) domain scores in patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH).

METHODS

This was a post hoc analysis of a double-blind, randomised, placebo-controlled, parallel-group, multicentre study in sexually active patients, aged ≥50 years, with a confirmed clinical diagnosis of BPH. Sexual activity, sexual desire, and bother domain scores of the MSHQ were assessed at baseline and at Months 1, 3, 6, 9, and 12. Correlation between MSHQ sexual activity/desire scores and ejaculation, erection, and satisfaction domains at baseline was also evaluated.

RESULTS

In the intent-to-treat population (N = 489), 243 and 246 patients were randomised to DUT-TAM FDC and placebo groups, respectively. Compared with placebo, DUT-TAM FDC therapy resulted in statistically significant reductions (worsening) from baseline in adjusted mean MSHQ sexual activity and bother domain scores at Months 1, 3, 6, 9, and 12 (all P < 0.05) and in adjusted mean MSHQ sexual desire domain scores at Months 6, 9, and 12 (all P < 0.05). Significant moderate correlations in the expected direction were observed at baseline between the sexual activity/desire domains and the ejaculation, erection, and satisfaction domains (P < 0.0001).

CONCLUSIONS

These findings help clarify the degree and impact of libido changes in sexually active men treated with DUT-TAM FDC and may support clinical decision-making.

摘要

目的

5-α 还原酶抑制剂(5ARI)治疗与一些患者的性功能障碍有关。本研究评估了固定剂量的 5ARI 度他雄胺 0.5mg 和 α-肾上腺素能受体拮抗剂坦索罗辛 0.4mg(DUT-TAM FDC)联合治疗对良性前列腺增生(BPH)继发下尿路症状患者的男性健康问卷(MSHQ)各域评分的影响。

方法

这是一项针对双盲、随机、安慰剂对照、平行组、多中心研究的事后分析,研究对象为年龄≥50 岁、有明确临床 BPH 诊断且有性生活的患者。在基线和治疗 1、3、6、9 和 12 个月时评估 MSHQ 的性生活、性欲望和困扰域评分。还评估了 MSHQ 性生活/欲望评分与基线时射精、勃起和满意度域之间的相关性。

结果

在意向治疗人群(N=489)中,243 例和 246 例患者分别被随机分配到 DUT-TAM FDC 组和安慰剂组。与安慰剂相比,DUT-TAM FDC 治疗从基线开始在调整后的平均 MSHQ 性生活和困扰域评分在治疗 1、3、6、9 和 12 个月时(均 P<0.05)和调整后的平均 MSHQ 性欲望域评分在治疗 6、9 和 12 个月时(均 P<0.05)显著恶化。在基线时观察到性生活/欲望域与射精、勃起和满意度域之间存在预期方向的显著中度相关性(均 P<0.0001)。

结论

这些发现有助于阐明接受 DUT-TAM FDC 治疗的有性生活的男性的性欲变化程度和影响,并可能支持临床决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c49/6767409/26e2a1d18eaa/IJCP-73-1-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c49/6767409/55cb4c14c6ae/IJCP-73-1-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c49/6767409/92b3bb92e934/IJCP-73-1-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c49/6767409/26e2a1d18eaa/IJCP-73-1-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c49/6767409/55cb4c14c6ae/IJCP-73-1-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c49/6767409/92b3bb92e934/IJCP-73-1-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c49/6767409/26e2a1d18eaa/IJCP-73-1-g003.jpg

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