University of California at Los Angeles and Urological Sciences Research Foundation, Los Angeles, California, USA.

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We evaluated the efficacy and safety of silodosin for treatment of benign prostatic hyperplasia symptoms in 2 randomized, placebo controlled, phase 3 studies.

Men 50 years or older with an International Prostate Symptom Score of 13 or greater and peak urinary flow rate of 4 to 15 ml per second received placebo or 8 mg silodosin daily with breakfast for 12 weeks. The primary end point was International Prostate Symptom Score change from baseline to last observation. Change in peak urinary flow rate was a secondary end point. Differences in treatment efficacy were assessed by ANCOVA.

Of 923 patients (mean age 65 years) 466 received silodosin and 457 placebo. After 0.5 week (range 3 to 4 days) of treatment patients receiving silodosin vs placebo achieved significant improvement in total International Prostate Symptom Score (difference -1.9, p < 0.0001) and irritative (-0.5, p = 0.0002) and obstructive (-1.4, p < 0.0001) subscores. The mean +/- SD change from baseline in total International Prostate Symptom Score was -4.2 +/- 5.3 for silodosin vs -2.3 +/- 4.4 for placebo. Differences (silodosin vs placebo) in International Prostate Symptom Score and subscores increased by week 12 (p < 0.0001). Mean change from baseline in peak urinary flow rate (ml per second) 2 to 6 hours after initial dose was greater (p < 0.0001) with silodosin (2.8 +/- 3.4) than placebo (1.5 +/- 3.8). Differences remained significant (p < 0.001) through week 12. The most common treatment emergent adverse event was (mostly mild) retrograde ejaculation (silodosin 28.1% of patients, placebo 0.9%). Few patients receiving silodosin (2.8%) discontinued because of retrograde ejaculation. Proportions of patients with treatment emergent orthostatic hypotension were similar for silodosin (2.6%) and placebo (1.5%).

Treatment with silodosin produced rapid improvement in urinary symptoms that was sustained for 12 weeks. Silodosin was well tolerated with a low incidence of orthostatic hypotension.

Written by:
Marks LS, Gittelman MC, Hill LA, Volinn W, Hoel G.   Are you the author?

Reference:
J Urol. 2009 Jun;181(6):2634-40.
doi:10.1016/j.juro.2009.02.034

PubMed Abstract
PMID:19371887

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