Comparison of phytotherapy (Permixon) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients.

BACKGROUND: Controversy regarding the relative efficacy of treatments for the relief of the symptoms of benign prostatic hyperplasia (BPH). METHODS: This was a 6-month double-blind randomized equivalence study that compared the effects of a plant extract (320 mg Permixon) with those of a 5 alpha-reductase inhibitor (5 mg finasteride) in 1,098 men with moderate BPH using the International Prostate Symptom Score (IPSS) as the primary end-point. RESULTS: Both Permixon and finasteride decreased the IPSS (-37% and -39%, respectively), improved quality of life (by 38 and 41%), and increased peak urinary flow rate (+25% and +30%, P = 0.035), with no statistical difference in the percent of responders with a 3 ml/sec improvement. Finasteride markedly decreased prostate volume (-18%) and serum PSA levels (-41%); Permixon improved symptoms with little effect on volume (-6%) and no change in PSA levels. Permixon fared better than finasteride in a sexual function questionnaire and gave rise to less complaints of decreased libido and impotence. CONCLUSIONS: Both treatments relieve the symptoms of BPH in about two-thirds of patients but, unlike finasteride, Permixon has little effect on so-called androgen-dependent parameters. This suggests that other pathways might also be involved in the symptomatology of BPH.

Effect of an in vivo immunostimulant treatment on PMN functions: interaction with antibiotics in vitro.

The in vivo effect of immunostimulant treatment, bacterial ribosomes together with membranal proteoglycans (three tablets and three sprays daily during 4 days) in combination or not with in vitro amoxicillin or josamycin (range 5-50 micrograms/ml), has been studied on three related functions of polymorphonuclear cells (PMN) isolated from human blood: adhesion, spontaneous and oriented migration. The immunostimulant treatment always induces an increase of the three parameters. A positive effect of high concentrations of amoxicillin could be also observed on adhesion and gives rise to a great additional impact by associating it with immunostimulant treatment (control: 8.26 PMN/field; assay: 51.55 PMN/field). Spontaneous and oriented migration are not very altered by in vitro antibiotics. A very significant decrease of chemotaxis has been only observed with 50 microgram/ml of josamycin. However, the immunostimulant treatment compensates for this negative effect. The real increase in PMN activation produced by the immunostimulant treatment might extend its indications beyond prevention during antibiotherapy, for example in the acute phase of respiratory infections.

[Medical treatment of prostatic adenoma. Controlled trial: PA 109 vs placebo in 110 patients]. / Traitement médical de l'adénome prostatique. Essai contrôlé: PA 109 vs placebo chez cent dix patients.

110 patients presenting with a prostatic adenoma sufficiently symptomatic to be treated medically, but not requiring surgical management, were included in a controlled test whose effectiveness was assessed after one month on the basis of objective criteria (nocturnal pollakiuria, urinary output, postmictional residue) and subjective criteria (dysuria, patients' opinions). PA 109 appeared significantly more effective than a placebo, especially in the objective criteria (p less than 10(-9]. Perfectly tolerated, clinically and biologically, this efficacy was again found in a supplementary study of forty seven patients, with a mean follow-up of 14.6 months, and over 2 1/2 years in some cases. Under the study conditions, and on the basis of the study criteria, PA 109 seems a good treatment for mictional disorders associated with non-surgical adenomas of the prostate.