Pretreatment Factors Associated With Pain Improvement After Cernitin Pollen Extract Therapy in Men With Chronic...

Cernitin pollen extract is used for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), but pretreatment factors associated with pain improvement remain unclear. This study explored baseline factors associated with clinically meaningful pain relief after cernitin therapy in men with CP/CPPS.

This exploratory post hoc analysis was based on a single-center, open-label, randomized prospective trial conducted between July 2017 and December 2018. Men with persistent CP/CPPS despite at least 12 weeks of α1-blocker therapy were randomized to receive add-on cernitin pollen extract or tadalafil for 12 weeks. The present analysis included 42 men assigned to cernitin. Good responders were defined as patients with a ≥ 50% improvement in the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) pain subscore. Baseline variables were compared, and exploratory logistic regression analysis with a limited number of covariates was performed.

Among 42 patients, 21 were good responders and 21 were poor responders. The NIH-CPSI pain subscore improved by 67.0% in good responders and by 28.9% in poor responders (p < 0.001). Baseline serum total testosterone was significantly lower in good responders than in poor responders (4.5 ± 2.9 vs. 6.3 ± 2.4 ng/mL; p = 0.006). In exploratory multivariable analysis, lower serum total testosterone remained the only factor associated with clinically meaningful pain improvement (odds ratio 0.53, 95% confidence interval 0.30-0.95; p = 0.033).

Lower pretreatment serum total testosterone was associated with clinically meaningful pain improvement after cernitin therapy. These findings are hypothesis-generating and require validation in larger prospective cohorts.