Abstract
Objectives: We examined the persistence rate with tadalafil for treatment of male lower urinary tract symptoms (LUTS) and explored the factors relevant to withdrawal. Patients and Methods: We retrospectively collected the data of male patients who received tadalafil treatment for LUTS. The persistence rate and the reason for withdrawal were investigated. Results: A total of 155 patients were examined. Mean age and mean observation period were 71.9 (48–93) years and 15.1 (1–52) months, respectively. During the observation period, 74 patients (48%) withdrew tadalafil. The Kaplan-Meier curve indicated a 58% persistence rate at 1 year. The reasons for withdrawal included insufficient efficacy (31 patients, 42%), adverse events (21 patients, 28%), or symptom improvement (8 patients, 11%). Patients who continued tadalafil were significantly younger than those who withdrew it due to insufficient efficiency (71.4 ± 9.6 vs. 74.9 ± 9.1 years). Conclusions: Most patients withdrew tadalafil due to insufficient efficacy. Older patients are likely to withdraw the treatment because of insufficient efficacy, thus, tadalafil for male LUTS could be more effective for younger patients.
References
1.
Yokoyama
O
, Yoshida
M
, Kim
SC
, Wang
CJ
, Imaoka
T
, Morisaki
Y
, et al. Tadalafil once daily for lower urinary tract symptoms suggestive of benign prostatic hyperplasia: a randomized placebo- and tamsulosin-controlled 12-week study in Asian men
. Int J Urol
. 2013
Feb
;20
(2
):193
–201
.
[PubMed]
0919-81722.
Oelke
M
, Giuliano
F
, Baygani
SK
, Melby
T
, Sontag
A
. Treatment satisfaction with tadalafil or tamsulosin vs placebo in men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH): results from a randomised, placebo-controlled study
. BJU Int
. 2014
Oct
;114
(4
):568
–75
.
[PubMed]
1464-40963.
Gacci
M
, Corona
G
, Salvi
M
, Vignozzi
L
, McVary
KT
, Kaplan
SA
, et al. A systematic review and meta-analysis on the use of phosphodiesterase 5 inhibitors alone or in combination with α-blockers for lower urinary tract symptoms due to benign prostatic hyperplasia
. Eur Urol
. 2012
May
;61
(5
):994
–1003
.
[PubMed]
0302-28384.
Wagg
A
, Compion
G
, Fahey
A
, Siddiqui
E
. Persistence with prescribed antimuscarinic therapy for overactive bladder: a UK experience
. BJU Int
. 2012
Dec
;110
(11
):1767
–74
.
[PubMed]
1464-40965.
Hakimi
Z
, Johnson
M
, Nazir
J
, Blak
B
, Odeyemi
IA
. Drug treatment patterns for the management of men with lower urinary tract symptoms associated with benign prostatic hyperplasia who have both storage and voiding symptoms: a study using the health improvement network UK primary care data
. Curr Med Res Opin
. 2015
Jan
;31
(1
):43
–50
.
[PubMed]
0300-79956.
Koh
JS
, Cho
KJ
, Kim
HS
, Kim
JC
. Twelve-month medication persistence in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia
. Int J Clin Pract
. 2014
Feb
;68
(2
):197
–202
.
[PubMed]
1368-50317.
Cairoli
C
, Reyes
LA
, Henneges
C
, Sorsaburu
S
. PDE5 inhibitor treatment persistence and adherence in Brazilian men: post-hoc analyses from a 6-month, prospective, observational study
. Int Braz J Urol
. 2014
May-Jun
;40
(3
):390
–9
.
[PubMed]
1677-55388.
Matsukawa
Y
, Majima
T
, Matsuo
K
, Funahashi
Y
, Kato
M
, Yamamoto
T
, et al. Effects of tadalafil on storage and voiding function in patients with male lower urinary tract symptoms suggestive of benign prostatic hyperplasia: A urodynamic-based study
. Int J Urol
. 2018
Mar
;25
(3
):246
–50
.
[PubMed]
0919-81729.
Zhao
C
, Kim
SH
, Lee
SW
, Jeon
JH
, Kang
KK
, Choi
SB
, et al. Activity of phosphodiesterase type 5 inhibitors in patients with lower urinary tract symptoms due to benign prostatic hyperplasia
. BJU Int
. 2011
Jun
;107
(12
):1943
–7
.
[PubMed]
1464-409610.
Morelli
A
, Filippi
S
, Sandner
P
, Fibbi
B
, Chavalmane
AK
, Silvestrini
E
, et al. Vardenafil modulates bladder contractility through cGMP-mediated inhibition of RhoA/Rho kinase signaling pathway in spontaneously hypertensive rats
. J Sex Med
. 2009
Jun
;6
(6
):1594
–608
.
[PubMed]
1743-609511.
Kawai
Y
, Oka
M
, Yoshinaga
R
, Fuchikami
C
, Oyama
T
. Effects of the phosphodiesterase 5 inhibitor Tadalafil on bladder function in a rat model of partial bladder outlet obstruction
. Neurourol Urodyn
. 2016
Apr
;35
(4
):444
–9
.
[PubMed]
0733-246712.
Kadekawa
K
, Majima
T
, Kawamorita
N
, Okada
H
, Yoshizawa
T
, Mori
K
, et al. Effects of an alpha1A/D-adrenoceptor antagonist, naftopidil, and a phosphodiesterase type 5 inhibitor, tadalafil, on urinary bladder remodeling in rats with spinal cord injury
. Neurourol Urodyn
. 2017
Aug
;36
(6
):1488
–95
.
[PubMed]
0733-246713.
Gotoh
D
, Torimoto
K
, Tatsumi
Y
, Hori
S
, Yamada
A
, Miyake
M
, et al. Tadalafil, a phosphodiesterase type 5 inhibitor, improves bladder blood supply and restores the initial phase of lower urinary tract dysfunction in diabetic rats
. Neurourol Urodyn
. 2018
Feb
;37
(2
):666
–72
.
[PubMed]
0733-246714.
Aikawa
K
, Yokota
T
, Okamura
H
, Yamaguchi
O
. Endogenous nitric oxide-mediated relaxation and nitrinergic innervation in the rabbit prostate: the changes with aging
. Prostate
. 2001
Jun
;48
(1
):40
–6
.
[PubMed]
0270-413715.
Lugg
JA
, Rajfer
J
, González-Cadavid
NF
. Dihydrotestosterone is the active androgen in the maintenance of nitric oxide-mediated penile erection in the rat
. Endocrinology
. 1995
Apr
;136
(4
):1495
–501
.
[PubMed]
0013-722716.
Nishizawa
O
, Yoshida
M
, Takeda
M
, Yokoyama
O
, Morisaki
Y
, Murakami
M
, et al. Tadalafil 5 mg once daily for the treatment of Asian men with lower urinary tract symptoms secondary to benign prostatic hyperplasia: analyses of data pooled from three randomized, double-blind, placebo-controlled studies
. Int J Urol
. 2015
Apr
;22
(4
):378
–84
.
[PubMed]
0919-817217.
Oelke
M
, Wagg
A
, Takita
Y
, Büttner
H
, Viktrup
L
. Efficacy and safety of tadalafil 5 mg once daily in the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia in men aged ≥75 years: integrated analyses of pooled data from multinational, randomized, placebo-controlled clinical studies
. BJU Int
. 2017
May
;119
(5
):793
–803
.
[PubMed]
1464-4096© 2020 S. Karger AG, Basel
2020
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.
