Department of Epidemiology, Biostatistics, Occupational Health, McGill University, Montréal, Canada.
Center for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montréal, Canada.
World J Urol. 2021 Jun;39(6):2019-2028. doi: 10.1007/s00345-020-03429-z. Epub 2020 Sep 9.
To describe trends in the pharmacological treatment of BPH in the United Kingdom (UK) from 1998 to 2016.
We created a cohort of men with a diagnosis of BPH between 1998 and 2016 using the Clinical Practice Research Datalink. Using Poisson regression, we estimated annual prescription rates of 5αRIs, α-blockers, and combination therapy (5αRIs + α-blockers). Adherence was defined by a proportion of days covered > 80%.
Our cohort included 192,640 men with BPH who generated 1,176,264 person-years (PYs) of follow-up. The mean age was 68.0 (standard deviation: 10.7) years. The prescription rate of all BPH medications during the study period was 347.6 per 100 PYs (95% CI 347.2-347.9). α-Blockers had the highest prescription rate (222.9 per 100 PYs, 95% CI 222.7-223.2); prescription rates of 5αRIs and combination therapy were 69.1 per 100 PYs (95% CI 69.0-69.3) and 55.5 per 100 PYs (95% CI 55.4-55.7), respectively. The prescription rate for combination therapy was 19 times greater in 2013-2016 than in 1998-2000 (rate ratio: 19.2, 95% CI 18.6-19.7), while the prescription rates for 5αRIs and α-blockers each doubled during this period (rate ratio: 1.86, 95% CI 1.84-1.88 and rate ratio: 2.02, 95% CI 2.01-2.04, respectively). The proportion of patients who were adherent at 1 year to 5αRIs (32.3%), α-blockers (44.0%), and combination therapy (45.6%) was low.
The prescription rate of BPH medications increased substantially between 1998 and 2016 in the UK, with the greatest relative increase observed with combination therapy. Adherence to BPH medications was low in this population-based study.
描述 1998 年至 2016 年英国（英国）中治疗 BPH 的药理学治疗趋势。
我们使用临床实践研究数据库创建了一个 1998 年至 2016 年间诊断为 BPH 的男性队列。使用泊松回归，我们估计了 5αRIs、α-阻滞剂和联合治疗（5αRIs + α-阻滞剂）的年处方率。通过覆盖率> 80％来定义依从性。
我们的队列包括 192640 名患有 BPH 的男性，他们的随访时间为 1176264 人年（PY）。平均年龄为 68.0（标准差：10.7）岁。在研究期间，所有 BPH 药物的处方率为每 100PYs 347.6（95％CI 347.2-347.9）。α-阻滞剂的处方率最高（每 100PYs 222.9，95％CI 222.7-223.2）；5αRIs 和联合治疗的处方率分别为每 100PYs 69.1（95％CI 69.0-69.3）和每 100PYs 55.5（95％CI 55.4-55.7）。2013-2016 年联合治疗的处方率是 1998-2000 年的 19 倍（比率：19.2，95％CI 18.6-19.7），而同期 5αRIs 和 α-阻滞剂的处方率均增加了一倍（比率：1.86，95％CI 1.84-1.88 和比率：2.02，95％CI 2.01-2.04）。1 年时患者对 5αRIs（32.3％），α-阻滞剂（44.0％）和联合治疗（45.6％）的依从率较低。
1998 年至 2016 年，英国 BPH 药物的处方率大幅上升，联合治疗的相对增幅最大。在这项基于人群的研究中，BPH 药物的依从性较低。
