Outcomes With Early Versus Delayed 5ARIs for Benign Prostatic Hyperplasia
Objectives: To investigate the clinical and economic impact of initial therapy with 5-alpha reductase inhibitor (5ARI) as monotherapy or in combination with alpha-adrenergic blocker (AB) in men being treated for benign prostatic hyperplasia (BPH).
Study Design: A retrospective database analysis was conducted in men aged >50 years treated for BPH between 2000 and 2007 among patients enrolled in the Henry Ford Health System health maintenance organization.
Methods: Time to clinical progression, defi ned as the occurrence of acute urinary retention (AUR) or BPH-related surgery, was compared for those with initial 5ARI therapy or early combination 5ARI + AB therapy (5ARI added within 30 days of initiating AB therapy) and for those with delayed combination 5ARI + AB therapy (>30 days to <180 days after initiating AB therapy).
Results: Of 244 men included in the analysis, 80% were classifi ed in the early 5ARI therapy cohort (47.3% received 5ARI monotherapy; 32.6% initiated 5ARI within 30 days of an AB) and 20% of patients were in the delayed cohort. Patients in the delayed cohort were more likely to have clinical progression (AUR or BPH-related surgery) compared with patients in the early cohort (11.1% vs 5.2%, P = .0128) and also incurred signifi cantly more BPH-related medical charges per month than patients in the early cohort ($373.18 vs $121.81, P = .0002).
Conclusions: These results suggest that early initiation of 5ARI therapy, either as monotherapy or in combination with AB therapy, may reduce the risk of clinical progression (AUR or BPH-related surgery) as well as BPH-related medical expenditures.
(Am J Pharm Benefits. 2011;3(6):e127-e134)
Study Design: A retrospective database analysis was conducted in men aged >50 years treated for BPH between 2000 and 2007 among patients enrolled in the Henry Ford Health System health maintenance organization.
Methods: Time to clinical progression, defi ned as the occurrence of acute urinary retention (AUR) or BPH-related surgery, was compared for those with initial 5ARI therapy or early combination 5ARI + AB therapy (5ARI added within 30 days of initiating AB therapy) and for those with delayed combination 5ARI + AB therapy (>30 days to <180 days after initiating AB therapy).
Results: Of 244 men included in the analysis, 80% were classifi ed in the early 5ARI therapy cohort (47.3% received 5ARI monotherapy; 32.6% initiated 5ARI within 30 days of an AB) and 20% of patients were in the delayed cohort. Patients in the delayed cohort were more likely to have clinical progression (AUR or BPH-related surgery) compared with patients in the early cohort (11.1% vs 5.2%, P = .0128) and also incurred signifi cantly more BPH-related medical charges per month than patients in the early cohort ($373.18 vs $121.81, P = .0002).
Conclusions: These results suggest that early initiation of 5ARI therapy, either as monotherapy or in combination with AB therapy, may reduce the risk of clinical progression (AUR or BPH-related surgery) as well as BPH-related medical expenditures.
(Am J Pharm Benefits. 2011;3(6):e127-e134)
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