{"id":370283,"date":"2024-01-01T00:01:00","date_gmt":"2023-12-31T23:01:00","guid":{"rendered":"https:\/\/medizinonline.com\/?p=370283"},"modified":"2023-11-24T17:40:49","modified_gmt":"2023-11-24T16:40:49","slug":"sabal-urtica-combination-an-evidence-based-treatment-option","status":"publish","type":"post","link":"https:\/\/medizinonline.com\/en\/sabal-urtica-combination-an-evidence-based-treatment-option\/","title":{"rendered":"Sabal-Urtica combination: an evidence-based treatment option"},"content":{"rendered":"\n

The extracts from saw palmetto fruits (Sabal serrulata) and nettle roots (Urtica dioica) have a synergistic effect that has been proven to alleviate BPH-associated LUTS symptoms. This is shown by the results of several randomized and placebo-controlled studies. A decisive advantage over many synthetic medications is the low risk of side effects of the Sabal-Urtica combination. <\/strong><\/p>\n\n\n\n

In men, hyperplasia of connective tissue, epithelial and\/or smooth muscle cells occurs in the transitional zone from around the fourth decade of life [1]. Benign prostatic hyperplasia (BPH) is exclusively a histological diagnosis, while LUTS (lower urinary tract symptoms)<\/em> describes a clinical picture of symptoms of the lower urinary tract caused by various causes [2]. If LUTS occurs in connection with BPH, this is referred to as “LUTS suggestive of BPH” or in German-speaking countries as “benign prostate syndrome” (BPS) [2]. LUTS are divided into bladder storage symptoms, bladder emptying symptoms and symptoms after micturition (Fig. 1)<\/strong> [3,4]. <\/p>\n

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\"\"<\/a><\/figure>\n<\/div>\n

Sabal-Urtica fixed combination: convincing cost-benefit profile<\/h3>\n\n

Phytopharmaceuticals are an established and evidence-based drug treatment option for BPH [5]. The fixed combination Prostaplant\u00ae-F<\/sup>(WS\u00ae<\/sup> 1541) contains 160 mg Sabal extract WS\u00ae<\/sup> 1473 and 120 mg Urtica extract WS\u00ae<\/sup> 1031 in one capsule [6]. This proprietary combination of active ingredients is also known as PRO 160\/120 and is characterized by a multifactorial mechanism of action with synergistic effects [6]. The efficacy of the phytopreparation in relieving BPH-associated LUTS symptoms has been proven in several clinical studies in comparison to placebo and in comparison to tamsulosin and finasteride: <\/p>\n\n

In a randomized controlled trial, the PRO 160\/120 arm showed an improvement in the IPSS (International Prostate Symptom Score) <\/em>from 18.6 to 11.1 points after six months, while the corresponding values in the placebo group were 19 and 17.6 points respectively (p=0.002) [7]. <\/p>\n\n

In another placebo-controlled study, the IPSS was reduced by an average of 53% after 96 weeks of PRO 160\/120 therapy compared to the placebo, residual urine was reduced by 44% and the quality of life index increased by 50% [8,9]. <\/p>\n\n

In a randomized study of 489 patients, PRO 160\/120 showed similar efficacy compared to finasteride: In the phyto group, the IPSS decreased from 11.3 to 6.5 points and in the finasteride arm from 12.6 to 6.9 points [10]. <\/p>\n\n

In a randomized, double-blind, multi-center comparative study over a treatment period of 60 weeks, PRO 160\/120 (2\u00d7\/d 1 capsule) achieved a comparable reduction in IPSS values to 0.4 mg tamsulosin [11]. <\/p>\n\n

The extracts of Sabal serrulata and Urtica dioica have a synergistic effect, which is characterized on the one hand by anti-inflammatory effects and on the other by a reduction in growth factors [12]. Recent data show that PRO160\/120 inhibits proinflammatory signaling pathways involved in the development and progression of BPH [13]. The anti-inflammatory effects are due, among other things, to a downregulation of the cytokines IL-6 and IL-8, which are correlated with the state of hyperplasia [16,17]. One advantage over synthetics is the low risk of side effects of PRO160\/120; there is no drop in blood pressure, dizziness or sexual disorders. <\/p>\n\n

Literature: <\/p>\n\n

    \n
  1. “Diagnosis and treatment of benign prostate syndrome (BPS)”, S2e guideline. Register number: 043-034, long version 5.0 – status February 2023, https:\/\/register.awmf.org\/assets\/guidelines\/043-034l_S2e_Diagnostik_Therapie_benignes_Prostatasyndrom_2023-04.pdf<\/a>, (last retrieval 09.11.223) <\/li>\n\n\n\n
  2. e.Medpedia: Benign prostatic hyperplasia (BPH) and benign prostatic syndrome (BPS), www.springermedizin.de\/emedpedia,<\/a>(last accessed 09.11.2023) <\/li>\n\n\n\n
  3. D’Ancona C, et al: The International Continence Society (ICS) report on the terminology for adult male lower urinary tract and pelvic floor symptoms and dysfunction. Neurourol Urodyn 2019; 38(2): 433-477. <\/li>\n\n\n\n
  4. Abrams P: New words for old: lower urinary tract symptoms for “prostatism”. BMJ 1994; 308(6934): 929-930.<\/li>\n\n\n\n
  5. Kirschner-Hermanns R, Funk P, Leistner N: WS PRO 160 I 120 mg (a combination of sabal and urtica extract) in patients with LUTS related to BPH. Ther Adv Urol 2019 Oct 11; 11: 1756287219879533.<\/li>\n\n\n\n
  6. Swissmedic: Medicinal product information,www.swissmedicinfo.ch\/accept.aspx,<\/a>(last accessed 09.11.2023) <\/li>\n\n\n\n
  7. 7 Metzker H, Kieser M, H\u00f6lscher U: Efficacy of a Sabal-Urtica combination preparation in the treatment of benign prostatic hyperplasia. Urologist B 4 1996: 292-300. <\/li>\n\n\n\n
  8. Oelke M, et al: Le syndrome prostatique b\u00e9nin, urologen.info, num\u00e9ro 3, juin 2019.<\/li>\n\n\n\n
  9. Lopatkin N, et al: Efficacy and safety of a combination of Sabal and Urtica extract in lower urinary tract symptoms–long-term follow-up of a placebo-controlled, double-blind, multicenter trial. Int Urol Nephrol 2007; 39(4): 1137-1146.<\/li>\n\n\n\n
  10. S\u00f6keland J, Albrecht J: Combination of Sabal and Urtica extract vs. finasteride in BPH (stages I to II according to Aiken). Comparison of therapeutic effectiveness in a one year double-blind study [Combination of Sabal and Urtica extract vs. finasteride in benign prostatic hyperplasia (Aiken stages I to II). Comparison of therapeutic effectiveness in a one year double-blind study]. Urologist A 1997 Jul; 36(4): 327-333. <\/li>\n\n\n\n
  11. Engelmann U, et al: Efficacy and safety of a combination of sabal and urtica extract in lower urinary tract symptoms. A randomized, double-blind study versus tamsulosin. Drug Research 2006; 56(3): 222-229. <\/li>\n\n\n\n
  12. Nickel JC, et al: Nutraceuticals in Prostate Disease: The Urologist’s Role. Rev Urol 2008; 10: 192-206. <\/li>\n\n\n\n
  13. Pigat N, et al: Combined Sabal and Urtica Extracts (WS\u00ae<\/sup> 1541) Exert Anti-proliferative and Anti-inflammatory Effects in a Mouse Model of Benign Prostate Hyperplasia. Frontiers in Pharmacology 2019, https:\/\/doi.org\/10.3389\/fphar.2019.00311<\/a><\/li>\n\n\n\n
  14. Hald T: Urodynamics in benign prostatic hyperplasia: a survey. Prostate Suppl 1989; 2: 69-77.<\/li>\n\n\n\n
  15. Oelke M, et al: Increase in detrusor wall thickness indicates bladder outlet obstruction (BOO) in men. World journal of urology 2002; 19(6): 443-452. <\/li>\n\n\n\n
  16. de Nunzio CD, et al: The Role of Inflammation in the Progression of Benign Prostatic Hyperplasia. Curr Bladder Dysfunct Rep 2013; 8: 142-149.<\/li>\n\n\n\n
  17. Saponaro M, et al: Serenoa repens and Urtica dioica Fixed Combination: In-Vitro Validation of a Therapy for Benign Prostatic Hyperplasia (BPH). Int J Mol Sci 2020; 21(23): 9178. <\/li>\n<\/ol>\n\n

    <\/p>\n\n

    FAMILY PHYSICIAN PRACTICE 2023; 18(11): 28<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

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