Combination dutasteride plus tamsulosin significantly improves symptom scores in men with IPSS =12, PSA =1.5-10 ng/ml, prostate volume =30 ml, flow rate 5-15 ml/sec (combAT)

Combination dutasteride plus tamsulosin significantly improves symptom scores in men with IPSS =12, PSA =1.5-10 ng/ml, prostate volume =30 ml, flow rate 5-15 ml/sec (combAT)

This study was different to MTOPS because it assessed only patients with a very high risk of BPH progression (prostate volume > 30 ml and/or PSA >1.5-10 ng/ml, a minimum IPSS 12, flow rate 5-15 ml/sec) rather than all comers, and it used the more potent dual 5 alpha reductase inhibitor dutasteride 0.5 mg daily rather than the type 2 selective inhibitor finasteride in combination with tamsulosin 0.4 mg daily a selective alpha blocker. 4844 men were >50 years with no previous prostate surgery. AT mean follow up 24 months the result were:

  • Decreases in IPSS by – 6 points combination, 5 dutasteride, 4 tamsulosin
  • Improved flow rate by – 2.4 ml/sec combination, 1.9 dutasteride, 0.9 tamsulosin
  • Prostate volume reduced – 27% combination, 29% dutasteride, 0 tamsulosin
  • PSA reduced – 50% combination and dutasteride
  • 5% withdrawal from side effects erectile dysfunction, retrograde ejaculation, decreased libido, ejaculation failure, decreased semen volume, nipple pain, no floppy iris syndrome, no breast cancer.

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