A randomized crossover study comparing patient preference for tamsulosin and silodosin in patients with lower urinary...

Patient preference for benign prostatic hyperplasia (BPH) treatment with the α(1)-blockers, tamsulosin or silodosin, was compared using patient-reported outcomes. Japanese patients with lower urinary tract symptoms associated with BPH were randomly allocated to either the T-S group (tamsulosin 0.2 mg orally once daily for 4 weeks then silodosin 4 mg orally twice daily for 4 weeks) or the S-T group (silodosin 4 mg orally twice daily for 4 weeks then tamsulosin 0.2 mg orally once daily for 4 weeks). The primary endpoint was the preferred drug for treatment continuation at 8 weeks, determined by a patient-reported questionnaire. In total, 102 patients (mean age 70.3 years) were enrolled and 84 (n = 42 per group) completed the study. A significant difference was observed between the proportion of patients who preferred tamsulosin (59/84 patients; 70.2%) and those who preferred silodosin (18/84 patients; 21.4%). A major reason for preference of either drug was 'good efficacy'. Incidence of adverse effects was significantly lower with tamsulosin (3/91 patients; 3.3%) than with silodosin (25/88 patients; 28.4%). These findings indicate that tamsulosin is very effective for BPH, has few adverse effects and that patients want to continue to use it.