Future Direction in Pharmacotherapy for Non-neurogenic Male Lower Urinary Tract Symptoms

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dc.contributor.authorSoler, Roberto [UNIFESP]
dc.contributor.authorAndersson, Karl-Erik
dc.contributor.authorChancellor, Michael B.
dc.contributor.authorChapple, Christopher R.
dc.contributor.authorGroat, William C. de
dc.contributor.authorDrake, Marcus J.
dc.contributor.authorGratzke, Christian
dc.contributor.authorLee, Richard
dc.contributor.authorCruz, Francisco
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionHosp Israelita Albert Einstein
dc.contributor.institutionWake Forest Univ
dc.contributor.institutionWake Forest Baptist Med Ctr
dc.contributor.institutionOakland Univ
dc.contributor.institutionSheffield Teaching Hosp NHS Fdn Trust
dc.contributor.institutionUniv Pittsburgh
dc.contributor.institutionUniv Bristol
dc.contributor.institutionLudwig Maximilians Univ Munchen
dc.contributor.institutionJames Buchanan Brady Fdn
dc.contributor.institutionUniv Porto
dc.date.accessioned2016-01-24T14:34:30Z
dc.date.available2016-01-24T14:34:30Z
dc.date.issued2013-10-01
dc.description.abstractBackground: the pathophysiology of male lower urinary tract symptoms (LUTS) is highly complex and multifactorial. the shift in perception that LUTS are not sex or organ specific has not been followed by significant innovations regarding the available drug classes.Objective: To review pathophysiologic mechanisms and clinical and experimental data related to the development of new pharmacologic treatments for male LUTS.Evidence acquisition: the PubMed database was used to identify articles describing experimental and clinical studies of pathophysiologic mechanisms contributing to male LUTS and, supported by them, new pharmacotherapies with clinical or experimental evidence in the field.Evidence synthesis: Several pathologic processes (eg, androgen signaling, inflammation, and metabolic factors) and targets (eg, the urothelium, prostate, interstitial cells, detrusor, neurotransmitters, neuromodulators, and receptors) have been implicated in male LUTS. Some newly introduced drugs, such as phosphodiesterase type 5 inhibitors and beta 3-adrenergic agonists, have just started broad use in clinical practice. Drugs with potential benefit, such as vitamin D3 receptor analogs, gonadotropin-releasing hormone antagonists, cannabinoids, and drugs injected into the prostate, have been evaluated in experimental studies and have progressed to clinical trials. However, safety and efficacy data for these drugs are still scarce. Some compounds with interesting profiles have only been tested in experimental settings (eg, transient receptor potential channel blockers, Rho-kinase inhibitors, purinergic receptor blockers, and endothelin-converting enzyme inhibitors).Conclusions: New pathophysiologic mechanisms of male LUTS are described that lead to the continuous development of new pharmacotherapies. To date, few drugs have been added to the current armamentarium, and several are in various phases of clinical or experimental investigation. (C) 2013 European Association of Urology. Published by Elsevier B.V. All rights reserved.en
dc.description.affiliationUniversidade Federal de São Paulo, Div Urol, São Paulo, Brazil
dc.description.affiliationHosp Israelita Albert Einstein, São Paulo, Brazil
dc.description.affiliationWake Forest Univ, Bowman Gray Sch Med, Inst Regenerat Med, Winston Salem, NC USA
dc.description.affiliationWake Forest Baptist Med Ctr, Dept Urol, Winston Salem, NC USA
dc.description.affiliationOakland Univ, William Beaumont Sch Med, Royal Oak, MI USA
dc.description.affiliationSheffield Teaching Hosp NHS Fdn Trust, Royal Hallamshire Hosp, Dept Urol, Sheffield, S Yorkshire, England
dc.description.affiliationUniv Pittsburgh, Sch Med, Dept Pharmacol & Chem Biol, Pittsburgh, PA USA
dc.description.affiliationUniv Bristol, Bristol Urol Inst, Bristol, Avon, England
dc.description.affiliationUniv Bristol, Sch Clin Sci, Bristol, Avon, England
dc.description.affiliationLudwig Maximilians Univ Munchen, Dept Urol, Munich, Germany
dc.description.affiliationJames Buchanan Brady Fdn, Weill Cornell Med Coll, Dept Urol, New York, NY USA
dc.description.affiliationUniv Porto, Dept Urol, Hosp S Joao, P-4200319 Oporto, Portugal
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Div Urol, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipAstellas
dc.description.sponsorshipEli Lilly
dc.format.extent610-621
dc.identifierhttp://dx.doi.org/10.1016/j.eururo.2013.04.042
dc.identifier.citationEuropean Urology. Amsterdam: Elsevier B.V., v. 64, n. 4, p. 610-621, 2013.
dc.identifier.doi10.1016/j.eururo.2013.04.042
dc.identifier.issn0302-2838
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/36814
dc.identifier.wosWOS:000323939900025
dc.language.isoeng
dc.publisherElsevier B.V.
dc.relation.ispartofEuropean Urology
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.rights.licensehttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
dc.subjectBenign prostatic hyperplasiaen
dc.subjectBladderen
dc.subjectLower urinary tract symptomsen
dc.subjectMaleen
dc.subjectPathophysiologyen
dc.subjectPharmacotherapyen
dc.subjectProstateen
dc.titleFuture Direction in Pharmacotherapy for Non-neurogenic Male Lower Urinary Tract Symptomsen
dc.typeinfo:eu-repo/semantics/article
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