About a third of older men with lower urinary tract symptoms obtained minimal benefit from tamsulosin and might be candidates for deprescribing.Only four patients in this study obtained substantial symptom relief.N-of-1 study design showed potential to identify patients who may benefit from alpha-blockers, facilitating a more personalized approach to treatment.
More than a third of older men with lower urinary tract symptoms (LUTS) derived little or no benefit from an alpha-blocker and might be candidates for "deprescribing," a small, randomized study suggested.
During active treatment in the crossover trial, 11 of the 30 patients had little or no symptom relief with the widely used alpha-blocker tamsulosin. An additional 11 had moderate improvement, and four patients could not tolerate the placebo run-in between assigned treatment periods, leaving only four patients (13.3%) who had strong benefits.
The findings suggest older men with LUTS and minimal benefit from tamsulosin might be "high-priority" candidates for treatment discontinuation or deprescribing, reported Scott R. Bauer, MD, of the University of California San Francisco, and colleagues in JAMA Network Open.
Additionally, the study provided evidence that an N-of-1 crossover trial design "can precisely quantify the individualized benefits and harms" of a treatment.
