title: Can we use baseline characteristics to assess which men with moderately symptomatic benign prostatic hyperplasia at risk of progression will benefit from treatment? A post hoc analysis of data from the 2-year CONDUCT study.
abstract: OBJECTIVE
  To investigate (in a post hoc analysis of the 2-year CONDUCT study) the characteristics and clinical outcomes of men with moderately symptomatic benign prostatic hyperplasia (BPH) at risk of progression who benefitted from lifestyle changes alone.
  
  
  METHODS
  Patients were given lifestyle advice and randomized to a fixed-dose combination (FDC) of dutasteride and tamsulosin or watchful waiting (WW) and followed for 24 months. Patients in the WW group were escalated to tamsulosin if any follow-up International Prostate Symptom Score (IPSS) was equal or greater than the baseline value. Improvements in symptoms (change in IPSS) and quality of life [measured by BPH Impact Index (BII) and question 8 of the IPSS (IPSS-Q8)] were analysed in the FDC group, men who initiated tamsulosin (WW-TAM) and men who received no medical intervention (WW-no treatment) and the impact of baseline variables on IPSS determined.
  
  
  RESULTS
  The adjusted mean decrease in IPSS, BII and IPSS-Q8 at each post-baseline visit over 24 months appeared greater in the FDC (n = 369) and WW-no treatment groups (n = 144) than in the WW-TAM group (n = 229). IPSS improvements appeared similar in the FDC group and WW-no treatment subgroup, except in patients with the greatest degree of bother at baseline (BII 7-13).
  
  
  CONCLUSIONS
  BII at baseline may be a more relevant indicator than symptom severity as to whether a patient with moderate symptoms should receive medical therapy or not.
authors.affiliation: Department of Urology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, J8 142, Dallas, TX, 75390-9110, USA. Claus.roehrborn@utsouthwestern.edu.
authors.forename: Claus G
authors.initials: CG
authors.lastname: Roehrborn
authors.affiliation: Department of Urology, Mendaro Hospital, Mendaro, Gipuzkoa, Spain.
authors.forename: Igor
authors.initials: I
authors.lastname: Oyarzabal Perez
authors.affiliation: Department of Urology, Antonius Hospital Sneek, Sneek, The Netherlands.
authors.forename: Erik P M
authors.initials: EP
authors.lastname: Roos
authors.affiliation: Urology Clinic, Uroandromed, Bucharest, Romania.
authors.forename: Nicolae
authors.initials: N
authors.lastname: Calomfirescu
authors.affiliation: GlaxoSmithKline, Research Triangle Park, NC, USA.|PAREXEL International, Durham, NC, USA.
authors.forename: Betsy
authors.initials: B
authors.lastname: Brotherton
authors.affiliation: GlaxoSmithKline, Urology, Classic and Established Products, GlaxoSmithKline, Madrid, Spain.
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Palacios
authors.affiliation: GlaxoSmithKline Pharmaceuticals, GlaxoSmithKline, Kiev, Ukraine.
authors.forename: Averyan
authors.initials: A
authors.lastname: Vasylyev
authors.affiliation: GlaxoSmithKline, Research Triangle Park, NC, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Manyak
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000627:therapeutic use*; D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use*; D000368:Aged; D018450:Disease Progression; D004359:Drug Therapy, Combination; D000068538:Dutasteride / Q000627:therapeutic use*; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D011470:Prostatic Hyperplasia / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012720:Severity of Illness Index; D013449:Sulfonamides / Q000627:therapeutic use*; D000077409:Tamsulosin; D016896:Treatment Outcome; D057832:Watchful Waiting
chemical_list: D058891:5-alpha Reductase Inhibitors; D058668:Adrenergic alpha-1 Receptor Antagonists; D013449:Sulfonamides; D000077409:Tamsulosin; D000068538:Dutasteride
keywords: BPH Impact Index; Benign prostatic hyperplasia; Dutasteride; Lower urinary tract symptoms; Tamsulosin; Watchful waiting