Pilot Study Investigating Safety and Efficacy of Tadalafil as Treatment for Benign Prostatic Hyperplasia (BPH) in Asian Men

• Change From Baseline to 4 Week and 8 Week Endpoints in International Prostate Symptom Score (IPSS) Total Score [ Time Frame: baseline, 4 and 8 weeks ] [ Designated as safety issue: No ]
  The IPSS Total Score is obtained by combining the scores of the responses to 1 through 7 component questions. Each question is scored from 0-5 for an IPSS range of 0-35 points; higher numerical scores from the IPSS questionnaire represent greater severity of symptoms.
• Change From Baseline to 4, 8, and 12 Week Endpoints in International Prostate Symptom Score (IPSS) - Irritative Subscore [ Time Frame: baseline, 4, 8, and 12 weeks ] [ Designated as safety issue: No ]
  The IPSS storage (irritative) subscore is defined as sum of scores for Questions 2, 4, and 7 of the IPSS. If scores for any of these questions are missing for a visit, the IPSS storage subscore will be reported as missing for that visit. Subscore totals range from 0 to 15; higher scores are indicative of greater irritation.
• Change From Baseline to 4, 8, and 12 Week Endpoints in International Prostate Symptom Score (IPSS) - Obstructive Subscore [ Time Frame: baseline, 4, 8, and 12 weeks ] [ Designated as safety issue: No ]
  The IPSS voiding (obstructive) subscore is defined as sum of scores for Questions 1, 3, 5, and 6 of the IPSS. If scores for any of these questions are missing for a visit, the IPSS voiding subscore will be reported as missing for that visit. Subscore totals range from 0 to 20; higher scores are indicative of greater obstruction.
• Change From Baseline to 4, 8, and 12 Week Endpoints in International Prostate Symptom Score (IPSS) - Nocturia Subscore [ Time Frame: baseline, 4, 8, and 12 weeks ] [ Designated as safety issue: No ]
  IPSS Question 7 is used to assess the frequency of nocturia. Scores range from 0 (low frequency of nocturia) to 5 (high frequency of nocturia).
• Change From Baseline to 12 Week Endpoint in Benign Prostatic Hyperplasia Impact Index (BPH-II) [ Time Frame: baseline, 12 weeks ] [ Designated as safety issue: No ]
  The BPH-BII is a 4-item, self-administered questionnaire evaluating impact of urinary problems on overall health and activity. Total scores range of 0 to 13; higher scores represent increased perceived impact of BPH-LUTS on overall health. If scores for any component question were missing for a visit, BPH-BII was reported as missing for that visit.
• Patient Global Impression of Improvement (PGI-I) Combined Categories - Frequencies [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  A scale that measures the patient's perception of improvement at the time of assessment compared with the start of treatment. The score ranges from 1 (very much better) to 7 (very much worse). Scores were combined to provide number of participants who indicated they were "worse" (scores of 5, 6, or 7), "no change" (score of 4), or "better" (scores of 1, 2, or 3).
• Clinician Global Impression of Improvement (CGI-I) Combined Categories - Frequencies [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  Measures clinician's perception of patient improvement of illness at the time of assessment compared with start of treatment. Scores range from 1 (very much better) to 7 (very much worse). Scores were combined to provide number of participants whose clinician indicated they were "worse" (scores of 5, 6, or 7), "no change" (score of 4), or "better" (scores of 1, 2, or 3).
• Change From Baseline to 12 Week Endpoint in Total, Waking, and Sleeping Voids (Average Number Per Week) Based on Median as Reported in Patient Voiding Dribble Diary [ Time Frame: baseline, 12 weeks ] [ Designated as safety issue: No ]
  Patient-completed diary that measures daytime frequency (waking voids) and nocturia (sleeping voids). Average number of waking voids per week, average number of sleeping voids per week, and average number of total voids (sleeping+waking) per week are reported.
• Change From Baseline to 12 Week Endpoint in Total Urinary Incontinence Episodes Per Week Based on Median as Reported in Patient Voiding Dribble Diary [ Time Frame: baseline, 12 weeks ] [ Designated as safety issue: No ]
  A patient-completed diary that measures urinary incontinence (UI) (leaks). Number of UI leaks per week are reported.
• Change From Baseline to 12 Week Endpoint in Voids With Terminal Micturition Dribble and Post Micturition Dribble Per Week Based on Median as Reported by Patient Voiding Dribble Diary [ Time Frame: baseline, 12 weeks ] [ Designated as safety issue: No ]
  A patient-completed diary that measures terminal dribble (dribble in the end of urination) and post-micturition dribble (dribble after urination).
• Change From Baseline to 12 Week Endpoint in Uroflowmetry Parameters - Peak Urine Flow Rate (Qmax) and Mean Urine Flow Rate (Qmean) [ Time Frame: baseline, 12 weeks ] [ Designated as safety issue: No ]
  Qmax: defined as the peak urine flow rate (measured in milliliters per second [mL/second] using a standard calibrated flowmeter); and Qmean, defined as the mean urine flow rate (measured in mL/second using a standard calibrated flowmeter).
• Change From Baseline to 12 Week Endpoint in Uroflowmetry Parameters - Voided Urine Volume (Vcomp) [ Time Frame: baseline, 12 weeks ] [ Designated as safety issue: No ]
  Vcomp, defined as the volume of voided urine (measured in milliliters [mL]).

• IPSS total score [ Time Frame: 4 and 8 weeks ]
• IPSS subscores [ Time Frame: 4, 8, and 12 weeks ]
• BPH-II, Patient Diary, Uroflowmetry parameters, and symptom improvement scales [ Time Frame: 12 weeks ]
• Safety [ Time Frame: 12 weeks ]

The primary purpose of this clinical trial is to evaluate the change in the International Prostate Symptom Score (IPSS) total score from the beginning of the study to the end of the study for subjects randomized to tadalafil 5mg once a day dosing and placebo once a day dosing for 12 weeks of treatment.

• Drug: Tadalafil
  5 mg once a day
  Other Names:

  • LY450190
  • Cialis
• Drug: Placebo
  once a day
• Drug: Tamsulosin
  0.2 mg once a day

• Experimental: Tadalafil
  Intervention: Drug: Tadalafil
• Placebo Comparator: Placebo
  Intervention: Drug: Placebo
• Active Comparator: Tamsulosin
  Intervention: Drug: Tamsulosin

Inclusion Criteria:

• Have Benign Prostatic Hyperplasia - Lower Urinary Tract Symptoms (BPH-LUTS) for at least 6 months prior to Visit 1.
• Agree not to use any other approved or experimental treatments for erectile dysfunction or BPH-LUTS during the study.
• Have not taken Finasteride therapy for at least 3 months prior to Visit 2.
• Have not taken Dutasteride therapy for at least 6 months prior to Visit 2.
• Have an International Prostate Symptom Score (IPSS) total score greater than or equal to 13 at Visit 2.

Exclusion Criteria:

• Prostate Specific Antigen (PSA) greater than 10.0 nanograms per milliliter (ng/mL) at Visit 1.
• Bladder Post Void Residual (PVR) greater than or equal to 300 mL by ultrasound at Visit 1.
• History of pelvic surgery, prostatectomy, radiotherapy, penile implant surgery, lower urinary tract malignancy or trauma.
• Urinary tract infection or inflammation or current antibiotic therapy for urinary tract infection at Visit 1.
• Glycosylated hemoglobin (HbA1c) greater than 9% at Visit 1.