Supplementary Material for: Factors considered by experienced urologists when selecting alpha-blockers for patients with lower urinary tract symptoms or benign prostatic hyperplasia according to age

Introduction: To examine the opinions of urology specialists on whether there are actual differences in efficacy among α1-blockers and to identify the factors that should be considered when prescribing these medications according to age.

Methods: We surveyed 50 South Korean urology specialists with over 3 years of clinical experience in secondary or tertiary hospitals in July-August 2021. The survey covered urologists' demographics, awareness of α1-blocker prescription differences, and key factors in α1-blocker selection based on LUTS severity and patient age.

Results: Overall, 82% of the respondents believed that there were differences in efficacy of α1-blockers in actual practice according to age. Over 90% of the respondents agreed on the need for head-to-head comparison studies to compare the effects of different α1-blockers. Regardless of the severity of LUTS, urologists prioritize cardiovascular side effects when prescribing α1-blockers to patients aged ≥70 years. Further, 19% of the urologists prioritized ejaculatory side effects for mild-to-moderate LUTS and 9% for severe LUTS (p < 0.001).

Conclusions: This study shows that head-to-head studies comparing the efficacy of different α1-blockers are highly valuable for the real-world clinical application of α1-blockers. Notably, urologists prioritize cardiovascular and ejaculatory side effects in older and younger patients while prescribing α1-blockers, respectively.

引言：本研究旨在探讨泌尿科专家对于α1-受体阻滞剂在疗效上是否存在实际差异的观点，并识别在根据年龄开具此类药物时应当考虑的因素。
方法：我们于2021年7月至8月对50名具有超过3年临床经验的韩国泌尿科专家进行了调查，这些专家在二级或三级医院工作。调查内容涵盖泌尿科医生的人口统计学特征、对α1-受体阻滞剂处方差异的知晓程度，以及基于尿路刺激症状（LUTS）严重程度和患者年龄选择α1-受体阻滞剂的关键因素。
结果：总体而言，82%的受访者认为在实际临床实践中，根据年龄α1-受体阻滞剂的疗效存在差异。超过90%的受访者同意进行头对头比较研究，以比较不同α1-受体阻滞剂的效果。无论LUTS的严重程度如何，泌尿科医生在为≥70岁的患者开具α1-受体阻滞剂时，均优先考虑心血管副作用。此外，19%的泌尿科医生在轻度至中度LUTS情况下优先考虑射精副作用，而在重度LUTS情况下，这一比例则为9%（p < 0.001）。
结论：本研究表明，比较不同α1-受体阻滞剂疗效的头对头研究对于α1-受体阻滞剂在现实临床应用中的价值极大。值得注意的是，在开具α1-受体阻滞剂时，泌尿科医生在老年患者和年轻患者中分别优先考虑心血管和射精副作用。