Efficacy of dexamethasone in reducing the postembolisation syndrome in men undergoing prostatic artery embolisation for benign prostatic hyperplasia: protocol for a single-centre, randomised, double-blind, placebo-controlled trial-the 'DEXAPAE' study

Petra Svarc, Hein Vincent Stroomberg, Ruben Juhl Jensen, Susanne Frevert, Mats Håkan Lindh, Mikkel Taudorf, Klaus Brasso, Lars Lönn, Martin Andreas Røder, Petra Svarc, Hein Vincent Stroomberg, Ruben Juhl Jensen, Susanne Frevert, Mats Håkan Lindh, Mikkel Taudorf, Klaus Brasso, Lars Lönn, Martin Andreas Røder

Abstract

Introduction: Postembolisation syndrome (PES) is the most common side effect of vascular embolisation of solid organs. Although prophylactic corticosteroids are known to reduce the incidence and severity of PES, no trials investigating their efficacy have been conducted in men undergoing prostatic artery embolisation (PAE). We postulate that steroids can have a similar effect in reducing PES after PAE. This paper describes the rationale and detailed protocol for a randomised controlled trial evaluating the efficacy of dexamethasone (DEXA) in reducing PES after PAE.

Methods and analysis: In this single-centre, randomised, double-blind, placebo-controlled trial, we will enrol 60 individuals undergoing PAE for benign prostatic hyperplasia. Participants will be randomised to receive IV DEXA (24 mg) or placebo (saline). The primary outcomes will be postprocedural fever, pain and quality of life. The secondary outcomes will include postprocedural nausea, postprocedural medicine usage, laboratory parameters (C reactive protein, prostate-specific antigen) and early PAE results.

Ethics and dissemination: Ethics approval was obtained from the Danish Committee on Health Research Ethics in the Capital Region (H-20025910). The results from this trial will be disseminated through publication in peer-reviewed journals and national and international presentations.

Trial registration number: Clinicaltrials.gov identifier: NCT04588857; EudraCT number: 2020-000915-53.

Keywords: adult urology; interventional radiology; prostate disease.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Study flow and eligibility criteria. BPH, benign prostatic hyperplasia; eGFR, estimated glomerular filtration rate; INR, international normalised ratio; IPSS, International Prostate Symptom Score; LUTS, lower urinary tract symptoms; PCa, prostate cancer; Qmax, maximum flow velocity; TURP, transurethral resection of the prostate; UTI, urinary tract infection.

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