Drug development for LUTS – The challenge for industry

Lower urinary tract symptoms (LUTS) have long been an acknowledged complex of clinical manifestations related to a wide variety of urinary function. For a simplified way of addressing LUTS in a diagnostic and therapeutic approach, symptoms were brought into context of either prostate or the bladder pathology. However, current research and development of pharmaceutical agents requires understanding of the complex interaction of receptor pathways, and efferent and afferent signalling processes to successfully target the pathophysiological mechanisms that lead to clinical symptoms of LUTS. Drug development for this indication faces various challenges due to changing treatment paradigms and the evolved understanding of the disease. It is necessary to reflect this in the relationship to real-life clinical practice, bearing in mind patients’ perspective, physicians’ choices, cost-effectiveness, and the need to develop drugs in the context of what is driving care-seeking behaviour.