Cai Tommaso, Gallelli Luca, Cione Erika, Verze Paolo, Palmieri Alessandro, Mirone Vincenzo, Bonkat Gernot, Wagenlehner Florian M, Bjerklund Johansen Truls E
Department of Urology, Santa Chiara Regional Hospital, Trento, Italy -
Institute of Clinical Medicine, University of Oslo, Oslo, Norway -
Minerva Urol Nephrol. 2022 Dec;74(6):780-788. doi: 10.23736/S2724-6051.21.04141-2. Epub 2021 Mar 29.
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) remains a challenging clinical condition to manage. Here, we evaluate the efficacy and tolerability of a new treatment option (suppositories) containing pollen extract in combination with hyaluronic acid and vitamins in the management of patients with CP/CPPS.
In this prospective, randomized, controlled, single-blinded, phase-III study we enrolled CP/CPPS patients between March and December 2019. Participants were randomized (1:1) to the following treatment groups: 1) pollen extract suppositories 1 daily for 10 days; or 2) ibuprofen 600 mg 1 tablet in the morning for 10 days. At the enrolment time and at the follow-up evaluations (3, 6 months), all patients completed baseline questionnaires ([National Institutes of Health Chronic Prostatitis Symptom Index [NIH-CPSI] and Quality of Well-Being [QoL]) and underwent urological examination and microbiological evaluation. The primary endpoint was the quality-of-life assessment with Patients' Reported Outcomes (PROs).
One hundred and eighty-seven patients were screened. Finally, one hundred and twenty-four patients (mean age 34.6±3.9 years) were randomly allocated to the new pollen extract treatment (N.=63) or ibuprofen (N.=61) groups. At the end of follow-up examinations 56/63 group 1 patients (88.8%) showed a significant reduction of the NIH-CPSI total score, compared with 17/61 (27.8%) in group 2 (P<0.0001). Group 1 patients also reported a higher improvement in terms of PROs, when compared with the control group and group 1 patients reported a significant reduction of leucocyte count at the Meares-Stamey Test (-12; -4; P<0.001). Only mild adverse events were reported in the two groups and adverse events were less frequent in the pollen extract suppositories group.
The combination of pollen extract with hyaluronic acid and vitamins is more effective than ibuprofen in improving symptoms and Quality of Life in patients affected with CP/CPPS and has less side effects.
慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)仍是一种难以处理的临床病症。在此,我们评估一种含有花粉提取物、透明质酸和维生素的新治疗方案(栓剂)在CP/CPPS患者管理中的疗效和耐受性。
在这项前瞻性、随机、对照、单盲的III期研究中,我们纳入了2019年3月至12月期间的CP/CPPS患者。参与者被随机(1:1)分配到以下治疗组:1)花粉提取物栓剂,每日1次,共10天;或2)布洛芬600毫克,每天早上1片,共10天。在入组时和随访评估(3个月、6个月)时,所有患者均完成基线问卷([美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI)和生活质量(QoL)]),并接受泌尿外科检查和微生物学评估。主要终点是采用患者报告结局(PROs)进行的生活质量评估。
共筛查了187例患者。最终,124例患者(平均年龄34.6±3.9岁)被随机分配至新的花粉提取物治疗组(n = 63)或布洛芬组(n = 61)。在随访检查结束时,第1组56/63例患者(88.8%)的NIH-CPSI总分显著降低,而第2组为17/61例(27.8%)(P<0.0001)。与对照组相比,第1组患者在PROs方面也有更高的改善,并且第1组患者在梅尔斯-斯塔米试验中的白细胞计数显著降低(-12;-4;P<0.001)。两组均仅报告了轻度不良事件,且花粉提取物栓剂组的不良事件发生频率较低。
花粉提取物与透明质酸和维生素的组合在改善CP/CPPS患者的症状和生活质量方面比布洛芬更有效,且副作用更少。