N-of-1 Trials Reveal One-Third of Older Men Gain No Tamsulosin Benefit
This proof-of-concept crossover trial demonstrates that individualized placebo-controlled deprescribing trials can quantify who actually benefits from chronic tamsulosin, providing a structured tool for pharmacist-led deprescribing in older men.
Tamsulosin may not be necessary for many older men with minimal symptoms.
Deprescribing tamsulosin in older men with lower urinary tract symptoms (LUTS) may reduce unnecessary medication use without compromising care. About 37% of participants showed minimal or no symptomatic benefit from tamsulosin, suggesting potential for successful deprescribing. This study highlights the utility of N-of-1 trials in identifying patients who may not benefit from continued tamsulosin, emphasizing personalized deprescribing approaches. One in three older men on tamsulosin may experience minimal benefit, making them strong candidates for deprescribing.
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Authors:Bauer SR, Kenfield SA, Oni-Orisan A, Shlipak MG, Lu K, Rios N, Pearce R, Harmon J, McCulloch CE, Huang L, Steinman MA, Breyer BN
Citation:Bauer SR, Kenfield SA, Oni-Orisan A, et al. Tamsulosin Deprescribing for Lower Urinary Tract Symptoms in Older Men: A Randomized Clinical Trial. JAMA network open. 2026;9(7):e2621639. doi:10.1001/jamanetworkopen.2026.21639