Ulys Albertas, Černiauskienė Aušra, Geavlete Petrișor, Larsen Finn, MacLean Carol M, van Os Steve
National Cancer Institute, Santariskių Str. 1, LT-08660, Vilnius, Lithuania.
Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania.
Int Urol Nephrol. 2025 Feb;57(2):427-433. doi: 10.1007/s11255-024-04235-x. Epub 2024 Oct 20.
To evaluate the efficacy and safety of teverelix in treatment naïve patients aged over 50 years with symptomatic benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS), and to explore teverelix' potential in preventing AUR secondary to BPH with the aim to inform a planned Phase 2 trial.
This Phase 2, multicenter, randomized, double-blind, placebo-controlled study involved BPH patients with an International Prostate Symptom Score (IPSS) ≥ 13 and uroflow < 13 mL/sec. After a 4-week single-blind placebo run-in, patients were randomized to receive teverelix 60 mg (n = 41) or placebo (n = 40) subcutaneously on day 1 and day 3. The primary endpoint was IPSS reduction at end of treatment period (Week 16); secondary endpoints included uroflow, prostate volume (PV), pharmacokinetics, pharmacodynamics, quality of life (QoL), and safety. Data were analyzed using analysis of covariance with α set at 0.05.
At Week 16, teverelix significantly reduced IPSS by a mean of 6.3 (SD: ± 3.9) versus 1.1 (SD: ± 2.9) for placebo. By Week 2, teverelix showed a mean IPSS reduction of 13.0% compared to 3.8% for placebo, reaching 34.5% by Week 16 versus 5.2% for placebo. Clinically relevant IPSS reductions were observed in 44% of teverelix patients by Week 2, increasing to 83% by Week 12. Teverelix also achieved a significant 11% reduction in PV within 4 weeks, improved maximum urinary flow rate, and enhanced QoL scores.
Teverelix shows potential as an effective, well-tolerated treatment for LUTS secondary to BPH, with rapid and sustained benefits. The significant prostate volume reduction suggests that teverelix may help prevent recurrent AUR, warranting further dedicated studies.
评估替沃利克斯治疗50岁以上初治有症状良性前列腺增生(BPH)和下尿路症状(LUTS)患者的疗效和安全性,并探索替沃利克斯预防BPH继发急性尿潴留(AUR)的潜力,为计划中的2期试验提供依据。
这项2期、多中心、随机、双盲、安慰剂对照研究纳入了国际前列腺症状评分(IPSS)≥13且尿流率<13 mL/秒的BPH患者。经过4周的单盲安慰剂导入期后,患者在第1天和第3天被随机分组,皮下注射替沃利克斯60 mg(n = 41)或安慰剂(n = 40)。主要终点是治疗期结束时(第16周)IPSS的降低;次要终点包括尿流率、前列腺体积(PV)、药代动力学、药效学、生活质量(QoL)和安全性。使用协方差分析进行数据分析,α设定为0.05。
在第16周时,替沃利克斯使IPSS显著降低,平均降低6.3(标准差:±3.9),而安慰剂组为1.1(标准差:±2.9)。到第2周时,替沃利克斯组IPSS平均降低13.0%,安慰剂组为3.8%;到第16周时,替沃利克斯组达到34.5%,安慰剂组为5.2%。在第2周时,44%的替沃利克斯组患者观察到具有临床意义的IPSS降低,到第12周时增至83%。替沃利克斯在4周内还使PV显著降低了11%,改善了最大尿流率,并提高了QoL评分。
替沃利克斯显示出作为治疗BPH继发LUTS的有效且耐受性良好的治疗方法的潜力,具有快速且持续的益处。前列腺体积的显著减小表明替沃利克斯可能有助于预防复发性AUR,值得进一步开展专门研究。