BERKELEY, CA (UroToday.com) - The crucial point of our article is to prove the effectiveness and safety of low-dose (0.2 mg) tamsulosin, which could affect the widened indication of low-dose tamsulosin in both Asian as well as Western countries. This could affect the current trend of 0.4mg tamsulosin as a standard initial treatment strategy in Western countries.
Like other alpha blockers, at least 3 months are needed to judge the final outcome of initial low-dose tamsulosin. The main pitfall for urologists in judging the treatment outcome before 3 months is that any drug could be effective, especially in those patients who had severe lower urinary tract symptoms. The same phenomenon could be applied in placebo, too.
This issue is limited to patients whose chief complaint is voiding symptoms, as those patients with storage-predominant symptoms could be more successfully treated initially with a combination strategy of anticholinergics. Other alpha blockers are used in standard dose like in Western countries, and low-dose of other alpha blockers have been scarcely investigated. About the issue of whether low-dose tamsulosin has the same efficacy as other standard-dosed alpha blockers, another meta-analysis has been done and is currently under review. This meta-analysis shows that low-dose tamsulosin has a similar efficacy to other alpha blockers.
Low-dose tamsulosin should be the first treatment strategy, not only in Asian countries but also in Western countries, however, detailed prospective studies with low-dose tamsulosin in Western countries are needed. In a few months, another manuscript by our team, about the indication of low-dose tamsulosin as an initial treatment strategy, will be published.
In the current era, we are living with a flood of drugs. The prevalence of lower urinary tract symptoms is high in older populations who are more vulnerable and also have polypharmacy. The effort of lowering dose, if it is reasonable, should be maintained. To date, too many reports only emphasize increasing the dose.
Written by:
Jae Heon Kim, MD, PhD as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University School of Medicine, Seoul, Korea
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