29-Week Doxazosin Treatment in Patients with Symptomatic Benign Prostatic Hyperplasia

Abstract

In a placebo-controlled study, the safety and efficacy of the selective alpha 1-adrenoceptor-blocking agent doxazosin 4 mg once daily in the symptomatic treatment of benign prostatic hyperplasia (BPH) were evaluated. One hundred patients were primarily included in a 9-weeks study, and after this 75 patients accepted to continue in the present 20 weeks extension. Of the patients in the doxazosin-group (DG) 61% reported overall improvement against 53% in the placebo-group (PG)--(p = 0.56). In the DG, 49% of obstructive symptoms were improved compared to 27% in the PG (p < 0.01), and a reduction of 60% of irritative symptoms was found in the DG against 36% in the PG (p < 0.01). Daytime frequency was reduced by median 1.5 in the DG and remained unchanged in the PG (p < 0.01). Nocturia was reduced by median 1 and 0.5 respectively (p = 0.06). Maximum urinary flow rate (MFR) was improved by median 1.5 ml/s in the DG, while it deteriorated by median 0.5 ml/s in the PG (p < 0.05), Considering postvoid residual urine volume, cystometry variables (first sensation and bladder capacity), changes in sexual function and adverse events there was no difference between the two groups. In conclusion, doxazosin 4 mg once daily in long-term treatment of patients with BPH reduces both obstructive and irritative symptoms, daytime voiding frequency and although only slightly, significantly augments MFR without interference with sexual function and without other serious adverse effects.

The α1C‐adrenoceptor in human prostate: cloning, functional expression, and localization to specific prostatic cell types

“…Using radioligand binding, the al-adrenoceptors were identified in human prostatic tissue (Lepor & Shapiro, 1984). Most importantly, clinical trials involving al antagonists proved that blockade of ocl-adrenoceptors was effective in relieving BPH symptoms (Caine, 1986;Kirby, 1989;Kawabe et al, 1990;Lepor, 1990;Holme et al, 1994).…”

Long‐term (4 year) efficacy and tolerability of doxazosin for the treatment of concurrent benign prostatic hyperplasia and hypertension

“…Furthermore, doxazosin produced a significant 10 mmHg reduction in diastolic blood pressure in hypertensive patients, which was also sustained throughout the 4 years. Generally, the incidence of adverse events was low, as has been reported in other studies; 10,[12][13][14]17 adverse events were higher in hypertensives compared with normotensives, although this may be explained by the fact that the permitted dose for hypertensives was twice that of normotensives. Importantly, there was no increased incidence of adverse events over 4 years, even though the mean dose for the long-term cohort of hypertensive patients was higher than that for all hypertensives.…”

“…10,12,13 The data reported in the current 4-year study show that the efficacy of doxazosin therapy is clearly maintained in the long term in patients with concomitant hypertension and BPH, despite the fact that the disease processes worsen over time. Improvements in urodynamic parameters and in symptomatology, which are seen within weeks, 7,16 persisted throughout the 4 years studied in this analysis.…”

“…It is an established first-line therapy for hypertension and has proven efficacy in relieving symptoms of BPH in both normotensive and hypertensive patients. [9][10][11][12][13] In 3-4-month double-blind studies, doxazosin, in addition to improving BPH symptoms, was clinically effective in reducing blood pressure in hypertensive patients but had only minimal effects in normotensive patients.…”

Multicenter Drug Use Evaluation of Tamsulosin and Availability of Guidance Criteria for Nonformulary Use in the Veterans Affairs Health System

“…[1][2][3][4][5][6][7][8][9] Other (α)-blockers are also effective and available for treating patients with symptomatic BPH (e.g., terazosin, prazosin, doxazosin), [10][11][12][13][14][15][16][17][18][19][20][21] all of which are available by generic name, at lower cost. The effectiveness of tamsulosin and other α-blockers appear to be similar in the reduction of symptoms of BPH.…”