Alfuzosin Treatment Of Recently Diagnosed And Newly Symptomatic Alpha-blocker Naïve Patients With Chronic Prostatitis/Chronic Pain Syndrome

Main Category: Urology / Nephrology
Also Included In: Prostate / Prostate Cancer;  Pain / Anesthetics
Article Date: 12 Jun 2008 - 1:00 PDT

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ORLANDO, FL (UroToday.com) - Results from the NIH Randomized Multicenter Double-Blind Placebo Controlled Trial.

Dr. Nickel presented the use of alfuzosin in the treatment of chronic prostatitis and chronic pelvic pain syndrome (CP/CPPS). CP is extremely prevalent with 6-9% of men suffering from this. Treatment of CP is more costly in North America than treatment for type II diabetes mellitus, he said.

Traditional therapies of antibiotics are known not to work as well as previously hoped. Alpha-blockers relax smooth muscle, improve voiding symptoms, affect alpha receptors in the central nervous system and have an anti-inflammatory effect in the lower urinary tract. A treatment effect in randomized clinical trials is noted with alpha-blockers, especially in patients not previously taking alpha-blockers. Thus, their trial included 270 men randomized to alfuzosin vs. placebo and powered to detect a difference in response rates of 40-60%. Eleven clinical centers had good recruitment distribution. Baseline patient characteristics were similar in both arms. 14% of patients withdrew and adverse events occurred in only 5%.

The primary outcome was a greater that 4 point drop in the NIH-CPSI total score. There was a response of 49% in placebo arm and 49% in the alfuzosin arm! This result does not support the use of alfuzosin in the treatment of CP.

Presented by J. Curtis Nickel, MD, at the Annual Meeting of the American Urological Association (AUA) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA.

Reported by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS

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