Drug Combo Treats Overactive Bladder
Study Shows 2 Drugs May Be Better Than 1 for Some Men
Nov. 14, 2006 -- Some men with overactive bladder may benefit from treatment
with two drugs instead of one, a new study shows.
The study appears in The Journal of the American Medical
The researchers included Steven Kaplan, MD, of the urology department at New
York's Weill Cornell Medical College.
They studied 879 men with overactive bladder and enlarged prostate (benign
prostatic hyperplasia or BPH).
The men were at least 40 years old (average age: 61-63). They reported at
least "moderate bother" from their overactive bladder.
Symptoms of overactive bladder include urgent feeling to urinate and
increased frequency of urinating during the day and night. Men with BPH can
experience overactive bladder symptoms as a result of their prostate
Kaplan's team split the men into four groups.
For 12 weeks, each group followed one of these drug plans:
Detrol LA and Flomax
- Detrol LA
- Placebo (pills containing no medicine)
The men kept diaries during the study of their bladder symptoms.
They were also asked if they had had any treatment benefits, and if so, how
big those benefits were, after one, six, and 12 weeks of treatment.
Eighty percent of the men who took both Detrol LA and Flomax reported
improvement by 12 weeks, compared with 62% of those taking the placebo.
For instance, they reported urinating once less per day and bigger gains in
quality-of-life surveys than the placebo group.
The percentage of men reporting improvement who only took one drug -- Detrol
LA or Flomax -- was similar to the percentage reporting improvement in the
Dry mouth was the most commonly reported side effect, noted in 21% of the
men on combination therapy and 7% of those taking only one drug.
The researchers call for longer studies of the combination drug therapy and
they note a "large placebo response," possibly linked to the symptom
A journal editorial states that "although these findings may provide a
treatment option for some men with lower urinary tract symptoms, the relatively
short duration of the study (12 weeks) and the rather modest clinical benefits
must be balanced against the potential for adverse effects that may occur with
longer-term use of the drug combination."
The editorialists are Phil Fontana Rosa, MD, MBA, and Helene Cole, MD.
Fontana Rosa is executive deputy editor of The Journal of the American
Medical Association. Cole is a contributing editor for the journal.
Kaplan's study was funded by Pfizer, which makes Detrol LA. Pfizer is a