Korean J Urol.  2007 Feb;48(2):195-198. 10.4111/kju.2007.48.2.195.

Effectiveness of Loxoprofen Sodium on Nocturia in Patients with Benign Prostatic Hyperplasia

Affiliations
  • 1Department of Urology, Keimyung University School of Medicine, Daegu, Korea. cikim@dsmc.or.kr

Abstract

PURPOSE: The effectiveness of Loxoprofen sodium, a non-steroidal anti-inflammatory drug (NSAID), on the nocturia in patients with benign prostatic hyperplasia (BPH), not responding to anticholinergics or hypnotics, as well as alpha-blockers and 5 alpha reductase inhibitors, were investigated.
MATERIALS AND METHODS
Between October 2004 and June 2005, 150 BPH patients with 2 or more episodes of nocturia, despite treatments with anticholinergics or hypnotics, were enrolled in this study. Loxoprofen, 60mg/day, was orally administered prior to sleeping for 2 weeks. The number of episodes of nocturia was assessed before and after treatment according to baseline number of episodes of nocturia, age distribution, prostate volume and previous nocturia treatment.
RESULTS
The number of nocturia episodes decreased by at least 1 in 74.7% (112/150) of patients, and decreased by 2 or more, 1 and were unchanged or increased were 48.0, 26.7 and 25.3% of patients, respectively. In baseline nocturia > or =6 group, the nocturia decreased by 1 or more in 85.0%. Treatment-emergent adverse events, including gastric discomfort (12 patients, 8.0%), weak urinary stream (5 patients, 3.3%) and leg edema (2 patients, 1.3%), occurred in 19 of the 150 (12.7%) patients. There were no withdrawals resulting from adverse events. CONCLISIONS: Loxoprofen can be effectively combined as a treatment option for patients with BPH complaining of unresolved nocturia. However, studies on the mechanism of action, long term effectiveness and adverse events of Loxoprofen are necessary.

Keyword

Benign prostatic hyperplasia; Nocturia; Anti-inflammatory agents, non-steroidal

MeSH Terms

5-alpha Reductase Inhibitors
Age Distribution
Anti-Inflammatory Agents, Non-Steroidal
Cholinergic Antagonists
Edema
Humans
Hypnotics and Sedatives
Leg
Nocturia*
Prostate
Prostatic Hyperplasia*
Rivers
Sodium*
5-alpha Reductase Inhibitors
Anti-Inflammatory Agents, Non-Steroidal
Cholinergic Antagonists
Hypnotics and Sedatives
Sodium

Reference

1. Blanker MH, Bohnen AM, Groeneveld FP, Bernsen RM, Prins A, Ruud Bosch JL. Normal voiding patterns and determinants of increased diurnal and nocturnal voiding frequency in elderly men. J Urol. 2000. 164:1201–1205.
2. DuBeau CE, Yalla SV, Resnick NM. Implications of the most bothersome prostatism symptom for clinical care and outcomes research. J Am Geriatr Soc. 1995. 43:985–992.
3. Middelkoop HA, Smilde-van den Doel DA, Neven AK, Kamphuisen HA, Springer CP. Subjective sleep characteristics of 1,485 males and females aged 50-93: effects of sex and age, and factors related to self-evaluated quality of sleep. J Gerontol A Biol Sci Med Sci. 1996. 51:M108–M115.
4. Johnson TM, Jones K, Williford WO, Kutner MH, Issa MM, Lepor H. Changes in nocturia from medical treatment of benign prostatic hyperplasia: secondary analysis of the department of Veterans Affairs Cooperative Study Trial. J Urol. 2003. 170:145–148.
5. Bruskewitz RC, Larsen EH, Madsen PO, Dorflinger T. 3-year followup of urinary symptoms after transurethral resection of the prostate. J Urol. 1986. 136:613–615.
6. Wasson JH, Reda DJ, Bruskewitz RC, Elinson J, Keller AM, Henderson WG. A comparison of transurethral surgery with watchful waiting for moderate symptoms of benign prostate hyperplasia. The Veterans Affairs Cooperative Study Group on Transurethral Resection of the Prostate. N Engl J Med. 1995. 332:75–79.
7. Maggi CA. Prostanoids as local modulators of reflex micturition. Pharmacol Res. 1992. 25:13–20.
8. Weiss JP, Blaivas JG, Stember DS, Chaikin DC. Evaluation of the etiology of nocturia in men: the nocturia and nocturnal bladder capacity indices. Neurourol Urodyn. 1999. 18:559–565.
9. Han DY, Kim JS, Rim JS. Changes of voiding patterns with age in normal adult males. Korean J Urol. 2001. 42:1299–1304.
10. Nam SG, Moon DG, Kim JJ. Efficacy of desmopressin in treatment of adult nocturia. Korean J Urol. 2004. 45:49–55.
11. Anderson KE. Pharmacology of lower urinary tract smooth muscles and penile erectile tissues. Pharmacol Rev. 1993. 45:253–308.
12. Schussler B. Comparison of the mode of action of prostaglandin E2 (PGE2) and sulprostone, a PGE2-derivative, on the lower urinary tract in healthy women. A urodynamic study. Urol Res. 1990. 18:349–352.
13. Al-Waili NS. Increased urinary nitrite excretion in primary enuresis: effects of indomethacin treatment on urinary and serum osmolality and electrolytes, urinary volumes and nitrite excretion. BJU Int. 2002. 90:294–301.
14. Al-Waili NS. Indomethacin suppository to treat primary nocturnal enuresis: double-blind crossover study. J Urol. 1989. 142:1290–1292.
15. Araki T, Yokoyama T, Kumon H. Effectiveness of a non-steroidal anti-inflammatory drug for nocturia on patients with benign prostatic hyperplasia: a prospective non-randomized study of loxoprofen sodium 60mg once daily before sleeping. Acta Med Okayama. 2004. 58:45–49.
16. Yokoyama O, Komatsu K, Ishiura Y, Akino H, Kodama K, Yotsuyanagi S, et al. Overactive bladder-experimental aspects. Scand J Urol Nephrol. 2002. 210:Suppl. 59–64.
17. Wen SF. Nephrotoxicities of nonsteroidal anti-inflammatory drugs. J Formos Med Assoc. 1997. 96:157–171.
18. Delaere KP, Debruyne FM, Moonen WA. The use of indomethacin in the treatment of idiopathic bladder instability. Urol Int. 1981. 36:124–127.
19. Andersson KE. Treatment of overactive bladder: other drug mechanisms. Urology. 2000. 55(5A):Suppl. 51–57.
20. Palea S, Toson G, Pietra C, Trist DG, Artibani W, Romano O, et al. Pharmacological characterization of thromboxane and prostanoid receptors in human isolated urinary bladder. Br J Pharmacol. 1998. 124:865–872.
21. Waikakul S, Waikakul W. A post marketing survey on the side-effects of loxoprofen. J Med Assoc Thai. 1999. 82:721–726.
22. Griffin MR, Yared A, Ray WA. Nonsteroidal antiinflammatory drugs and acute renal failure in elderly persons. Am J Epidemiol. 2000. 151:488–496.
Full Text Links
  • KJU
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr