Dutasteride improved urinary symptoms better than tamsulosin, data show.


PARIS—Dutasteride is more effective than tamsulosin for treating men with moderate-to-severe urinary symptoms of BPH, data suggest.

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The findings come from the Combination of Avodart and Tamsulosin (COMBAT) study, which is designed to investigate whether dutasteride and tamsulosin work better in combination or as single agents in BPH sufferers.


Claus Roehrborn, MD, professor of urology at the University of Texas Southwestern Medical Center in Dallas, and his colleagues examined data from the first two years of the COMBAT study to compare the tamsulosin and dutasteride single therapies for the treatment of symptoms and low urinary flow in patients with moderate and severe symptoms of BPH (prostate size 30 cc or greater).


The tamsulosin and dutasteride groups had 1,611 and 1,623 patients, respectively. Every three months, patients were asked to complete an International Prostate Symptom Score (IPSS) survey to estimate symptom improvement compared with baseline. Results were reported in mean change from baseline. The second parameter was peak urinary flow (Qmax).


Tamsulosin treatment led to a more rapid decline in symptoms than dutasteride (-4.5 vs. -2.8 points at month 3), the researchers reported here at the Société Internationale d’Urologie 29th Congress. By month 12, however, symptom improvement was equal (-4.5 in the tamsulosin group and -4.2 in the dutasteride group), and from month 21 on, symptoms were improved to a greater degree in the dutasteride group (-4.9) than in the tamsulosin group (-4.3) at month 24.


Additionally, Qmax improved to a greater extent at the later time points in the dutasteride group than in the tamsulosin recipients. Patients undergoing both treatments showed an equal improvement in Qmax at month 6 (+1.2 mL/sec). The dutasteride group, however, continued to show improvement from month 12 (+1.5 mL/sec) through month 24 (+1.9 mL/sec), whereas the tamsulosin group showed no significant improvement in Qmax from month 12 through month 24 (+0.9 mL/sec).