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Evaluating the efficacy and safety of silodosin on nocturia in patients with benign prostatic hyperplasia: A multicenter, prospective, open-label, single-arm, phase IV trial

  • Kang Jun Cho 1,
  • Jeong Zoo Lee 6,
  • Yun Seob Song 5,
  • Jong Bo Choi 4,
  • Dae Kyung Kim 3,
  • Yong Tae Kim 2,
  • Joon Chul Kim 1
1 Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea 2 Department of Urology, Hanyang University College of Medicine, Seoul, Republic of Korea 3 Department of Urology, Eulji University School of Medicine, Daejeon, Republic of Korea 4 Department of Urology, Ajou University School of Medicine, Suwon, Republic of Korea 5 Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunghyang University College of Medicine, Seoul, Republic of Korea 6 Department of Urology, School of Medicine, Pusan National University, Busan, Republic of Korea

DOI: doi.org/10.1016/j.urology.2018.07.008

Objective

To evaluate the efficacy and safety of silodosin on nocturia in patients with benign prostatic hyperplasia (BPH).

Materials and Methods

This was a 12-week, single-arm, open-label, prospective, multicenter study. The study included men aged 50 years or older with nocturia (≥2 events/night) based on a voiding diary, an International Prostate Symptom Score (IPSS) ≥8, and a quality of life score ≥3. Enrolled patients received 8 mg of silodosin once daily for 12 weeks. We evaluated changes in the mean number of nocturia episodes (using a voiding diary) from baseline to the final assessment. Safety assessments included the rate of adverse events and adverse drug reactions.

Results

There were 118 patients included in the safety evaluation analysis, and 112 patients in the full analysis set group. The number of nocturia episodes decreased significantly after 12 weeks of treatment with silodosin (−1.12 ± 1.05, P < .0001). The secondary efficacy variables, including IPSS, overactive bladder symptom score and International Consultation on Incontinence Questionnaire-Nocturia score, also improved with treatment (P < .0001). There were abnormal drug reactions in 11.8% of patients. The most common adverse drug reaction was an ejaculatory disorder (7.6%). There were no significant adverse drug reactions reported.

Conclusion

Silodosin was found to be safe and effective in the treatment of nocturia in patients with BPH.

Dr. Rahnama'i

The treatment of nocturia remains a challenge, given its complex multifactorial aetiology. Benign prostatic obstruction (BPO) is one of various factors that plays a role in nocturia.

In this multicenter, open-label, single-arm, 12-week, phase IV study, 135 men with an International Prostate Symptom Score (IPSS) ≥8, quality of life score (QoL) ≥3 and ≥2 episodes of nocturia per night were included. The results show that selective α1A-adrenoceptor antagonist Silodisin 8mg once daily, can decrease the nocturia episodes significantly after 12 weeks of treatment  (-1.12±1.05, P<0.0001). The absolute number of nocturia episodes decreased from about 2,86 to about 1,74 episode per night. Therefore, the clinical relevance of a reduction of approximately one episode per night is not uncertain. It is known that medical or surgical desobstruction could reduce nocturia episodes. However, the most important factor in treating patients with nocturia remains a correct diagnosis and recognition of the underlying factors.