Evidence map›Paper›PMID 33337513›Full record

ArticleWorld journal of urology2021

Impact of early vs. delayed initiation of dutasteride/tamsulosin combination therapy on the risk of acute urinary retention or BPH-related surgery in LUTS/BPH patients with moderate-to-severe symptoms at risk of disease progression.

Salvatore D'Agate, Chandrashekhar Chavan, Michael Manyak, Juan Manuel Palacios-Moreno, Matthias Oelke, Martin C Michel, Claus G Roehrborn, Oscar Della Pasqua

Open access · hybridAbstract readComparative Study
In one paragraph

Article in World journal of urology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
2.4field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

  1. Guideline
  2. Review
  3. Review
  4. Article
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 8 institutions in 5 countries.

Salvatore D'AgateClinical Pharmacology and Therapeutics Group, University College London, BMA House, Tavistock Square, London, WC1H 9JP, UK.
Chandrashekhar ChavanGlobal Medical Urology, GlaxoSmithKline, Mumbai, India.
Michael ManyakGlobal Medical Urology, GlaxoSmithKline, Philadelphia, USA.
Juan Manuel Palacios-MorenoGlobal Medical Urology, GlaxoSmithKline, Tres Cantos, Spain.
Matthias OelkeDepartment of Urology, St. Antonius Hospital, Gronau, Germany.
Martin C MichelDepartment of Pharmacology, Johannes Gutenberg University, Mainz, Germany.
Claus G RoehrbornDepartment of Urology, Texas Southwestern Medical Center, Dallas, TX, USA.
Oscar Della PasquaClinical Pharmacology and Therapeutics Group, University College London, BMA House, Tavistock Square, London, WC1H 9JP, UK. odp72514@gsk.com.ORCID http://orcid.org/0000-0002-6211-1430
GlaxoSmithKline (India) · INGlaxoSmithKline (Spain) · ESGlaxoSmithKline (United Kingdom) · GBGlaxoSmithKline (United States) · USJohannes Gutenberg University Mainz · DESouthwestern Medical CenterSt.-Antonius-Hospital Gronau · DEUniversity College London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate the effect of delayed start of combination therapy (CT) with dutasteride 0.5 mg and tamsulosin 0.4 mg on the risk of acute urinary retention or benign prostatic hyperplasia (BPH)-related surgery (AUR/S) in patients with moderate-to-severe lower urinary tract symptoms (LUTS) at risk of disease progression.

methodsUsing a time-to-event model based on pooled data from 10,238 patients from Phase III/IV dutasteride trials, clinical trial simulations (CTS) were performed to assess the risk of AUR/S up to 48 months in moderate-to-severe LUTS/BPH patients following immediate and delayed start of CT for those not responding to tamsulosin monotherapy. Simulation scenarios (1300 subjects/arm) were investigated, including immediate start (reference) and alternative delayed start (six scenarios 1-24 months). AUR/S incidence was described by Kaplan-Meier survival curves and analysed using log-rank test. The cumulative incidence of events as well as the relative and attributable risks were summarised stratified by treatment.

resultsSurvival curves for patients starting CT at month 1 and 3 did not differ from those who initiated CT immediately. By contrast, significant differences (p < 0.001) were observed when switch to CT occurs ≥ 6 months from the initial treatment. At month 48, AUR/S incidence was 4.6% vs 9.5%, 11.0% and 11.3% in patients receiving immediate CT vs. switchers after 6, 12 and 24 months, respectively.

conclusionsStart of CT before month 6 appears to significantly reduce the risk of AUR/S compared with delayed start by ≥ 6 months. This has implications for the treatment algorithm for men with LUTS/BPH at risk of disease progression.

Indexed as

5-alpha Reductase InhibitorsAcute DiseaseAdrenergic alpha-1 Receptor AntagonistsDisease ProgressionDrug CombinationsDutasterideHumansLower Urinary Tract SymptomsMaleProstatic HyperplasiaRisk AssessmentSeverity of Illness IndexSymptom AssessmentTamsulosinTime FactorsUrinary Retention5-alpha Reductase InhibitorsAdrenergic alpha-1 Receptor AntagonistsDrug CombinationsDutasterideTamsulosinAcute urinary retentionBenign prostatic hyperplasiaBPH-related surgeryClinical trial simulationsDutasterideLower urinary tract symptomsRelative riskTamsulosin

Identifiers

PMID33337513
PMCPMC8332595
OpenAlexW3116488694

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.