Tamsulosin Shows Promise for Overactive Bladder in Men

By Reuters Staff

January 29, 2021

NEW YORK (Reuters Health) - A short course of the alpha-blocker tamsulosin may be able to reduce multiple symptoms of overactive bladder (OAB) in men, new research suggests.

While the findings need confirmation, "we believe our results to be highly relevant (for) clinicians treating male OAB. Our study offered supportive evidence that tamsulosin is potentially an effective drug for male OAB, which has importance to clinical practice," the study team writes in Urology.

In their paper, Dr. Theodore Johnson II of Emory University, in Atlanta, and colleagues report results of a planned, exploratory analysis of the Male Overactive Bladder Trial in Veterans (MOTIVE) trial in which 116 male veterans with OAB received tamsulosin (0.4 mg daily) during the four-week run-in phase.

Treatment led to "statistically significant reductions in voiding frequency (11.3 to 10.0 voids/24 hours, p<.0001), urgency scores (mean 2.5 to 2.2 points, p<.0001), and nightly nocturia (2.1 to 1.8, p<.001)," they report.

"Not all participants experienced clinically meaningful reductions, though some had reductions that met minimal clinical important difference criterion and/or they improved sufficiently (urinary frequency <= 8 per 24 hours) so that they did not receive add-on treatment in MOTIVE," Dr. Johnson and colleagues note.

Greater urinary symptoms reported on a standard symptom questionnaire at baseline correlated with greater reductions in symptoms following treatment. Yet, baseline clinical measures such as a lower baseline uroflow rate, higher post-void residual volume, or greater degree of voiding symptoms at baseline, did not predict the degree of OAB improvement.

The benefit of tamsulosin for OAB symptoms did not appear to depend on presence or severity of symptoms suggestive of benign prostatic hyperplasia (BPH), the researchers note.

"We recognize our study is exploratory and that our results need confirmation. We believe our results recommend additional study to examine the effect of alpha-blocker therapy for OAB and to examine what available clinical indicators might predict OAB symptom improvement," they write.

If tamsulosin is confirmed through further research to be an effective medication for male OAB, "it is a reasonable medication to start first," with additional therapy added "as needed," they suggest.

"Starting drugs one at a time reduces polypharmacy, which is important given how many men with male OAB are older. Starting with tamsulosin for male OAB and adding behavioral therapy has also proven efficacious," they add.

The study had no commercial funding and the authors have no relevant disclosures.

SOURCE: http://bit.ly/39o5VtL Urology, online January 20, 2021.