نبذة مختصرة : Key Points Question Is frailty associated with increased risk of progression of benign prostatic hyperplasia (BPH) symptoms and serious adverse events among men receiving drug therapy? Findings In a cohort study of 3047 men with moderate-to-severe lower urinary tract symptoms due to suspected BPH, higher deficit accumulation frailty index was associated with a higher risk of clinical BPH progression, particularly among men receiving doxazosin with finasteride, and serious adverse events. Meaning These findings suggest that frail men with lower urinary tract symptoms due to suspected BPH are more likely to have progression of symptoms, despite drug therapy, as well as serious adverse events.
This cohort study examines the association between a deficit accumulation frailty index and clinical progression or serious adverse events among men using drug therapy for benign prostatic hyperplasia (BPH).
Importance Benign prostatic hyperplasia (BPH) in older men can cause lower urinary tract symptoms (LUTS), which are increasingly managed with medications. Frailty may contribute to both symptom progression and serious adverse events (SAEs), shifting the balance of benefits and harms of drug therapy. Objective To assess the association between a deficit accumulation frailty index and clinical BPH progression or SAE. Design, Setting, and Participants This cohort study used data from the Medical Therapy of Prostatic Symptoms trial, which compared placebo, doxazosin, finasteride, and combination therapy in men with moderate-to-severe LUTS, reduced urinary flow rate, and no prior BPH interventions, hypotension, or elevated prostate-specific antigen. Enrollment was from 1995 to 1998, and follow-up was through 2001. Data were assessed in February 2021. Exposures A frailty index (score range, 0-1) using 68 potential deficits collected at baseline was used to categorized men as robust (score ≤0.1), prefrail (score 0.1 to
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