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• W3190838834 abstract "You have accessJournal of UrologyBenign Prostatic Hyperplasia: Epidemiology & Evaluation (MP28)1 Sep 2021MP28-19 A NEW RISK CALCULATOR TO PREDICT CHANGES IN INTERNATIONAL PROSTATE SYMPTOM SCORE AND RISK OF RETENTION OR SURGERY IN BENIGN PROSTATIC HYPERPLASIA PATIENTS WITH MODERATE-SEVERE SYMPTOMS AT RISK OF DISEASE PROGRESSION RECEIVING PLACEBO, DUTASTERIDE, TAMSULOSIN, OR COMBINATION THERAPY Claus G Roehrborn, Juan Manuel Palacios, Douglas Thompson, Federico Concas, Piotr J Kamola, Stavros Gravas, Matthias Oelke, Michael Kattan, Marcio A Averbeck, Michael Manyak, and Zrinka Lulic Claus G RoehrbornClaus G Roehrborn More articles by this author , Juan Manuel PalaciosJuan Manuel Palacios More articles by this author , Douglas ThompsonDouglas Thompson More articles by this author , Federico ConcasFederico Concas More articles by this author , Piotr J KamolaPiotr J Kamola More articles by this author , Stavros GravasStavros Gravas More articles by this author , Matthias OelkeMatthias Oelke More articles by this author , Michael KattanMichael Kattan More articles by this author , Marcio A AverbeckMarcio A Averbeck More articles by this author , Michael ManyakMichael Manyak More articles by this author , and Zrinka LulicZrinka Lulic More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002025.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We developed a risk calculator using data from patients receiving placebo, dutasteride, tamsulosin or tamsulosin/dutasteride combination therapy coming from dutasteride trials to project the effect of treatment selection on the change in lower urinary tract symptoms (LUTS) and risk of acute urinary retention or BPH-related surgery (AUR/S). This was achieved through baseline characteristics that commonly define patient risk of disease progression. METHODS: The data included 9167 patients from three dutasteride vs placebo trials (ARIA3001, ARIA3002 and ARIB3003) and one trial comparing the active therapies dutasteride, tamsulosin and combination (CombAT). We selected covariates based on their diagnostic value: age, baseline International Prostate Symptom Score (IPSS), total prostate volume (PV), maximum urine flow rate (Qmax), prostate-specific antigen (PSA), and post-void residual urine (PVR), an alpha-blocker usage (yes/no) in the last 12 months, and randomised treatment. We developed two independent models to predict responses to active treatments over 4-year follow-up (f/u): (i) a Generalised Least Squares model for longitudinal IPSS and (ii) a Cox proportional hazards model for time-to-first AUR/S. We also trained two ‘placebo response’ models to benchmark the predicted outcomes to treatment for 2-year f/u. We used a state-of-the-art validation framework to make appropriate use of the selected data. RESULTS: Model performance was heterogeneous across studies. Predictions for active treatments were well-calibrated, with some indication of heterogeneity on unseen data. We deployed the prediction models as an interactive calculator to visualize outcomes for any user-provided combination of predictors meeting CombAT study entry criteria. For example, compared against the average patient profile in the data we used, we predict that for patients at relatively lower risk of disease progression (i.e. IPSS 12-19, PV 30-50 mL, PSA 1.5-4 ng/mL, Qmax >11 mL/s and PVR <70 mL), the combination of dutasteride and tamsulosin is more effective than tamsulosin to improve LUTS and reduce the incidence of AUR/S for up to 4 years. CONCLUSIONS: Visualising individual risks, and how those change depending on the choice of treatment (active or placebo), may support healthcare professionals and patients in making more personalised and data-driven decisions. Source of Funding: Sponsored by GSK © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e488-e488 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Claus G Roehrborn More articles by this author Juan Manuel Palacios More articles by this author Douglas Thompson More articles by this author Federico Concas More articles by this author Piotr J Kamola More articles by this author Stavros Gravas More articles by this author Matthias Oelke More articles by this author Michael Kattan More articles by this author Marcio A Averbeck More articles by this author Michael Manyak More articles by this author Zrinka Lulic More articles by this author Expand All Advertisement Loading ..." @default.
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• W3190838834 title "MP28-19 A NEW RISK CALCULATOR TO PREDICT CHANGES IN INTERNATIONAL PROSTATE SYMPTOM SCORE AND RISK OF RETENTION OR SURGERY IN BENIGN PROSTATIC HYPERPLASIA PATIENTS WITH MODERATE-SEVERE SYMPTOMS AT RISK OF DISEASE PROGRESSION RECEIVING PLACEBO, DUTASTERIDE, TAMSULOSIN, OR COMBINATION THERAPY" @default.
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