Tamsulosin Deprescribing for Lower Urinary Tract Symptoms in Older Men

Can placebo-controlled N-of-1 deprescribing trials accurately quantify the individualized benefits and harms of tamsulosin therapy for older men with lower urinary tract symptoms?In this crossover trial, among 30 participants who attempted the N-of-1 protocol, 11 (36.7%) demonstrated minimal or no effect of tamsulosin, 11 (36.7%) demonstrated moderate effect, 4 (13.3%) demonstrated a strong effect, and 4 (13.3%) did not tolerate the placebo run-in.In this proof-of concept randomized N-of-1 clinical trial of tamsulosin deprescribing, treatment response was highly heterogeneous and approximately 1 in 3 participants receiving tamsulosin therapy for benign prostatic hyperplasia had minimal or no effect of tamsulosin vs placebo on urinary symptoms.

Corresponding Author: Scott R. Bauer, MD, ScM, Division of General Internal Medicine, SFVA Medical Center, 4150 Clement St, Bldg 2, Room 135, San Francisco, CA 94121 (scott.bauer@ucsf.edu).

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