Adult urologyDiscontinuation of alpha-blockade after initial treatment with finasteride and doxazosin in men with lower urinary tract symptoms and clinical evidence of benign prostatic hyperplasia
Section snippets
Material and methods
Between June 1997 and June 1999, 272 men with an average age of 66 years were enrolled in this study. These men had prostates of 40 g or larger (average weight 54 g, range 40 to 104 g), American Urological Association (AUA) symptom scores of 20 or greater (range 20 to 33), and prostate-specific antigen levels of less than 4.0 ng/mL (or a prostate-specific antigen level between 4 and 10 ng/mL with a prostate biopsy negative for malignancy). The prostate size was measured by digital rectal
Results
Of the 272 men enrolled in this study, 240 reported a favorable response (defined as no increase in symptom score and toleration of study medications) to the initial combination regimen (5 mg finasteride and 2, 4, or 8 mg doxazosin) after 1 month. Of the 32 men who did not continue with the study, 11 reported no improvement in symptom score and 21 did not tolerate the study medications. The most frequent side effects were dizziness and orthostatic hypotension. In the patients discontinuing
Comment
Even though combination therapy is a popular treatment modality among urologists, there is a surprising lack of published reports on the subject. The Veterans Affairs study by Lepor et al.9 in 1996 is perhaps the most widely publicized. In their 1-year study, 1229 men with symptoms of bladder outlet obstruction were randomized to a placebo, finasteride, terazosin, or a combination of finasteride and terazosin. Lepor et al. concluded that terazosin alone was an effective treatment strategy,
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Cited by (62)
Medical Aspects of the Treatment of LUTS/BPH: Combination Therapies
2018, Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia: From Research to BedsideEffects of Withdrawing α1-Blocker from Combination Therapy with α1-Blocker and 5α-Reductase Inhibitor in Patients with Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia: A Prospective and Comparative Trial Using Urodynamics
2017, Journal of UrologyCitation Excerpt :Others also reported that discontinuing α1-blocker after 9 to 12 months of finasteride and doxazosin combination therapy did not result in deteriorating LUTS.14 However, the evaluation period after the switch to monotherapy in the 2 studies was only 4 and 12 weeks, respectively.13,14 Additionally, objective efficacy was not evaluated.
Prostate diseases
2017, FMC Formacion Medica Continuada en Atencion PrimariaEndocrinology of Benign Prostatic Hyperplasia and Prostate Cancer
2015, Endocrinology: Adult and PediatricUpdate in benign prostatic hyperplasia
2014, FMC Formacion Medica Continuada en Atencion PrimariaEndocrinology of the Prostate
2010, Endocrinology: Adult and Pediatric, Sixth Edition