Efficacy of α-blocker or 5-ARI Withdrawal to Continued Combination Therapy on the Maintenance of LUTS in Men With BPH

NCT ID: NCT05023824

Last Updated: 2021-08-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

300 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-12-08

Study Completion Date

2023-12-07

Brief Summary

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The investigators compare the efficacy of alpha-blocker and 5-ARI withdrawal to continued combination therapy on the maintenance of LUTS and improvement of quality of life outcomes in men with benign prostatic hyperplasia.

Detailed Description

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Benign Prostatic Hyperplasia (BPH) is the primary cause of lower urinary tract symptoms (LUTS). Combination therapy with an alpha-blocker and 5α reductase inhibitors (5-ARI) is the first-line treatment of BPH-related LUTS for the reduction of the size of the prostate and LUTS improvement. Combination therapy is tolerated well by most men; however, the incidence of adverse events is higher than with either therapy alone. In patients with improved LUTS following combination therapy, the aim of this study is based on the hypothesis that the withdrawal of either therapy will not increase the risk of LUTS aggravation while improving the quality of life.

The investigators plan a prospective, randomized, open-label, parallel trial, comparing alpha-blocker withdrawal and 5-ARI withdrawal to continued combination therapy. Treatments will be allocated in a 1:1:1 ratio, based on IPSS score (≤30% decrease from baseline) and prostate volume (≤35% decrease from baseline).

Conditions

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Prostatic Hyperplasia Prostate Hyperplasia Prostatic Hypertrophy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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alpha-blocker withdrawal

receives 5-ARI monotherapy

Group Type EXPERIMENTAL

alpha-blocker or 5-ARI withdrawal

Intervention Type DRUG

Withdrawal of either alpha-blocker or 5-ARI

5-ARI withdrawal

receives alpha-blocker monotherapy

Group Type EXPERIMENTAL

alpha-blocker or 5-ARI withdrawal

Intervention Type DRUG

Withdrawal of either alpha-blocker or 5-ARI

combination therapy

receives alpha-blocker and 5-ARI

Group Type ACTIVE_COMPARATOR

Maintenance of alpha-blocker and 5-ARI

Intervention Type DRUG

Maintenance of alpha-blocker and 5-ARI

Interventions

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alpha-blocker or 5-ARI withdrawal

Withdrawal of either alpha-blocker or 5-ARI

Intervention Type DRUG

Maintenance of alpha-blocker and 5-ARI

Maintenance of alpha-blocker and 5-ARI

Intervention Type DRUG

Other Intervention Names

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alpha-blocker withdrawal 5-ARI withdrawal

Eligibility Criteria

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Inclusion Criteria

* Men aged ≥50 or \<80 years AND
* On combination therapy (alpha-blocker and 5-ARI) ≥12 months AND
* IPSS score (≤30% decrease from baseline) AND
* Prostate volume (≤35% decrease from baseline)

Exclusion Criteria

* Suspected prostate cancer (PSA density \>0.15 ng/ml/cc) requiring specific management
* On-going prostatitis or urinary retention
* Acontractile detrusor
* Neurogenic lower urinary tract dysfunction
* Urethral stenosis
* Patient unable or unwilling to provide written informed consent
Minimum Eligible Age

50 Years

Maximum Eligible Age

80 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Gangnam Severance Hospital

OTHER

Sponsor Role lead

Responsible Party

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Kyo Chul Koo

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Kyo Chul Koo, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Yonsei University

Locations

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Gangnam Severance Hospital, Yonsei University College of Medicine

Seoul, , South Korea

Site Status RECRUITING

Countries

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South Korea

Central Contacts

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Kyo Chul Koo, MD, PhD

Role: CONTACT

82-01099480342

Kwang Suk Lee, MD, MMS

Role: CONTACT

82-01089246674

Facility Contacts

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Kyo Chul Koo, MD, PhD

Role: primary

82-01099480342

Kwang Suk Lee, MD, MMS

Role: backup

82-01089246674

References

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Barkin J, Guimaraes M, Jacobi G, Pushkar D, Taylor S, van Vierssen Trip OB. Alpha-blocker therapy can be withdrawn in the majority of men following initial combination therapy with the dual 5alpha-reductase inhibitor dutasteride. Eur Urol. 2003 Oct;44(4):461-6. doi: 10.1016/s0302-2838(03)00367-1.

Reference Type RESULT
PMID: 14499682 (View on PubMed)

Nickel JC, Barkin J, Koch C, Dupont C, Elhilali M. Finasteride monotherapy maintains stable lower urinary tract symptoms in men with benign prostatic hyperplasia following cessation of alpha blockers. Can Urol Assoc J. 2008 Feb;2(1):16-21. doi: 10.5489/cuaj.520.

Reference Type RESULT
PMID: 18542722 (View on PubMed)

Related Links

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https://pubmed.ncbi.nlm.nih.gov/18542722/

Finasteride monotherapy maintains stable lower urinary tract symptoms in men with benign prostatic hyperplasia following cessation of alpha blockers

https://pubmed.ncbi.nlm.nih.gov/14499682/

Alpha-blocker therapy can be withdrawn in the majority of men following initial combination therapy with the dual 5alpha-reductase inhibitor dutasteride

Other Identifiers

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3-2020-0451

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

3-2020-0451

Identifier Type: -

Identifier Source: org_study_id

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