Abstract
Purpose: To determine the effects of therapy with Urtica dioicafor symptomatic relief of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH).
Material and Methods: A 6-month, double-blind, placebo-controlled, randomized, partial crossover, comparative trial of Urtica dioicawith placebo in 620 patients was conducted. Patients were evaluated using the International Prostate Symptom Score (IPSS), the maximum urinary flow rate (Qmax), postvoid residual urine volume (PVR), Serum Pros-tatic-Specific Antigen (PSA), testosterone levels, and prostate size. At the end of the 6-month trial, unblinding revealed that patients who initially received the placebo were switched to Urtica dioica. Both groups continued the medication up to 18 months.
Results: Five hundred fifty-eight patients (90%) completed the study (287/305, 91% in the Urtica dioicagroup, and 271/315, 86% in the placebo group). By intention-to-treat analysis, at the end of the 6-month trial, 232 (81%) of 287 patients in the Urtica dioicagroup reported improved LUTS compared with 43 (16%) of 271 patients in the placebo group (P< 0.001). Both IPSS and Qmax showed greater improvement with drugs than with placebo. The IPSS went from 19.8 down to 11.8 with Urtica dioica and from 19.2 to 17.7 with placebo (P= 0.002). Peak flow rates improved by 3.4 mL/s for placebo recipients and by 8.2 mL/s for treated patients (P< 0.05). In Urtica dioicagroup, PVR decreased from an initial value of 73 to 36 mL (P< 0.05). No appreciable change was seen in the placebo group. Serum PSA and testosterone levels were unchanged in both groups. A modest decrease in prostate size as measured by transrectal ultrasonography (TRUS) was seen in Urtica dioicagroup (from 40.1 cc initially, to 36.3 cc; P< 0.001). There was no change in the prostate volume at the end of study with placebo. At 18-month follow-up, only patients who continued therapy, had a favorable treatment variables value. No side effects were identified in either group.
Conclusion: In the present study, Urtica dioicahas beneficial effects in the treatment of symptomatic BPH. Further clinical trials should be conducted to confirm these results before concluding that Urtica dioicais effective.
Additional information
Notes on contributors
Mohammad Reza Safarinejad
F. U. Alakbarov is Head Scientific Officer, expert in the Oriental and Folk Medicine, Institute of Manuscripts of the Azerbaijan Academy of Sciences, 8 Istiglaliyat str., Baku, 370001, Azerbaijan.
At the time of writing Liya Davydov was PharmD candidate, College of Pharmacy and Allied Health Professions, St. John’s University. Currently, she is Pharmacy Practice Resident, Mount Sinai Medical Center, New York, NY.
Ila Mehra Harris is Assistant Professor, Department of Pharmaceutical Care & Health Systems, College of Pharmacy, and Clinical Assistant Professor, Department of Family Practice & Community Health, Medical School, University of Minnesota, Minneapolis, MN.
Colin J. Briggs is Professor of Pharmacy, Faculty of Pharmacy, University of Manitoba. Recently he completed a secondment to Health Canada, as Senior Science Advisor in the Therapeutics Products Programme with special responsibility for complementary medicines.
Gemma Briggs is Research Assistant, IMPACT, The Injury Prevention Centre of Children’s Hospital, 501G-715 John Buhler Research Centre, Winnipeg, MB, Canada.
Mary Chavezis Professor of Pharmacy Practice, Director of Complementary Medicine Education and Research, The Center for the Advancement of Pharmacy Practice, Midwestern University, College of Pharmacy Glendale, Glendale, AZ 85308.
June Riedlinger was Director of the Center for Integrative Therapies in Pharmaceutical Care, Massachusetts College of Pharmacy and Health Sciences, Boston, MA. Currently he is Adjunct Associate Professor of Neuropathic Medicine, Southwest College of Naturopathic Medicine & Health Sciences, 2140 East Broadway Road, Tempe, AZ 85282.