Celebrex reduces frequency of nighttime urination

Taking a widely used arthritis drug could reduce swelling in men with an enlarged prostate, leading to less frequent nightly trips to the bathroom to urinate, new research published in the journal Urology shows.

The drug, celecoxib, sold in the U.S. as Celebrex, reduced the average number of times men got up each night from more than five than less than three, according to Dr. Alireza Noshad Kamran and colleagues from Guilan University of Medical Sciences in Rasht, Iran.

"This dramatic response is better than any known treatment, including alpha blockers and even surgery," the researchers write, adding: "It should be emphasized that any conclusion regarding the usefulness of this therapy can only be drawn from larger studies with long-term follow-up of the effects of celecoxib."

Benign prostate hyperplasia (BPH) is very common among older men. The condition results in enlargement, or hyperplasia, of the prostate, causing a persistent need or urge to urinate.

Nighttime urination is the most common symptom men discuss with their doctors, who may prescribe an alpha blocker, such as tamsulosin (brand name Flomax), or a 5-alpha reductase inhibitor such as finasteride (Proscar). However, these drugs only help 25 percent to 39 percent of patients, according to Kamran and his team.

Celecoxib is an anti-inflammatory drug that inhibits prostaglandins, compounds produced by several body tissues that have been shown to reduce urine production, among other functions. To investigate whether the drug might help reduce BPH symptoms, the researchers randomized 80 men to take 100 mg of celecoxib at 9 p.m. or placebo every night for a month.

Average nighttime urination fell from 5.17 times to 2.5 times for men in the celecoxib group, compared to from 5.30 to 5.12 in the placebo group. Men taking the drug also showed a significantly greater reduction in their score on a scale measuring BPH symptoms.

In addition, 82.5 percent of the men taking celecoxib showed improvements or stopped urinating at night entirely, while just 22.5 percent of men in the control group did.

No adverse effects were seen in men taking the drug, aside from "mild gastric discomfort" in four study participants.

"Our results suggest a novel treatment option for this common condition," Kamran and his colleagues conclude.

SOURCE: Urology, October 2008.