Subject : Prescribing Patterns and Preferences for Alpha Blocker + Dutasteride Combination Therapy in Management of LUTS/BPH Among Urologists
LUTS (lower urinary tract symptoms) suggestive of BPH (benign prostatic hyperplasia) are common in ageing men and are associated with a reduced quality of life (QoL) (Robertson C et al 2007) Numerous studies have reported a high prevalence of BPH, which affects nearly 40% of men aged > 50 years, with differences between countries, and its relationship with age. (Oesterling JE et al 1997, Awedew AF et al 2022) Two types of treatment coexist, pharmacotherapy and surgery; the increased availability of effective contemporary pharmacotherapy has led to a substantial decrease in the use of surgery.
Targets for medical treatment include G protein-coupled receptors (α1-adrenoceptors, muscarinic acetylcholine receptors, β3-adrenoceptors) or intracellular enzymes (5 α -reductase; phosphodiesterase-5, PDE5). Established therapies of obstructive symptoms aim to induce prostate smooth muscle relaxation by α 1-blockers or PDE5 inhibitors, or to reduce prostate growth and volume with 5 α -reductase inhibitors. (Hennenberg M et al 2007)
Clinical trials have shown that α1-adrenergic antagonists decrease LUTS and increase urinary flow rates in men with symptomatic BPH, but do not reduce the long-term risk of urinary retention or need for surgical intervention. Inhibitors of 5α-reductase decrease production of dihydrotestosterone within the prostate resulting in decreased prostate volumes, increased peak urinary flow rates, improvement of symptoms, and decreased risk of acute urinary retention and need for surgical intervention. Inhibitors of 5α-reductase decrease production of dihydrotestosterone within the prostate resulting in decreased prostate volumes, increased peak urinary flow rates, improvement of symptoms, and decreased risk of acute urinary retention and need for surgical intervention. (Miller J et al 2009)
Information on usage of alpha-blocker and 5α-reductase inhibitor combination is limited in Indian context. Thus, this survey is planned with an objective to evaluate current practice and perception of Urologist in the management of BPH and utilization of alpha blocker + dutasteride combination therapy
As you will be spending some extra time to give your feedback on the questionnaire based on your clinical experience, we offer to pay you by cheque a professional fee of 25,000 on receiving the completed Survey Questionnaire Form from you.
We trust you and we are partners in promoting safe and effective drug therapy. In that spirit we hope you will consent to participate in this study. If you do, please sign and return the enclosed reply along with your visiting card for accuracy of records.
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