Placebo‐controlled Study of Terazosin in the Treatment of Benign Prostatic Hyperplasia with 2‐Year Follow‐up

Fabricius, P. G.; Hannaford, J.

doi:10.1111/j.1464-410x.1992.tb15861.x

Cited by 22 publications

(9 citation statements)

References 13 publications

(10 reference statements)

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“…They were associated with longer treatment duration and lower post-treatment IPSS, which seemed to bring selfconfi dence without drugs. In contrast to the results of other investigators [9][10][11][12][13][14] , in the present study tamsulosin could be discontinued in approximately 70% of the patients at 24 weeks. A temporary worsening of both subjective and objective parameters was observed at 4 weeks, which mainly came from symptom deterioration in 6 patients requiring treatment resumption.…”

Section: Resultscontrasting

confidence: 55%

“…The reason for this high success rate is unknown. It may have been due to patient selection with respect to the criteria of symptom improvement and prostate size, and longer treatment courses than those in other reports [9][10][11][12][13][14] , or the use of tamsulosin, which was reported to be associated with a low rate of treatment failure compared with terazosin and alfuzosin [16] . Of these factors, treatment duration seems to be relevant for successful discontinuation.…”

Section: Resultsmentioning

confidence: 46%

“…So far, little is known about the sustainability of the effects of ␣ 1 -blockers in patients who respond to treatment. This point of issue has been the concern of a few studies only, as a placebo [9] or comparative arm [10,11] , or as ␣ 1 -blocker discontinuation in the combined treatment with 5 ␣ -reductase inhibitors [12][13][14] . Thus, none of these studies have focused on the issue of discontinuation of ␣ 1 -blockers themselves after initial symptom improvement.…”

Section: Resultsmentioning

confidence: 99%

“…Of these factors, treatment duration seems to be relevant for successful discontinuation. In previous reports, when ␣ 1 -blockers were discontinued after 3-6 months of treatment, symptom deterioration was observed [9,10,15] .…”

Section: Resultsmentioning

confidence: 99%

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Discontinuation of Tamsulosin Treatment in Men with Lower Urinary Tract Symptoms: A Pilot Study

2006

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Objectives: Since little investigation has been undertaken to determine if α₁-blockers should be given continuously to sustain their efficacy, we conducted a pilot study to determine symptom change following discontinuation of tamsulosin after an initial improvement in symptoms in men with lower urinary tract symptoms (LUTS). Patients and Methods: Thirty-three of 78 patients with mild-to-moderate prostate hyperplasia, who had symptom improvement according to the International Prostate Symptom Score (IPSS) to <10 or the quality of life (QOL) index to ≤3 after initial treatment with tamsulosin, were enrolled in this study. Subjective parameters (IPSS and QOL index) and objective parameters (maximum and mean urinary flow rates) were evaluated at baseline and after initial treatment, and 4, 8, 12 and 24 weeks after discontinuing tamsulosin. Results: The rates of successful discontinuation of tamsulosin were high throughout the follow-up period, i.e., 80.6% at 4 weeks, 80.6% at 8 weeks, 80.0% at 12 weeks, and 68.9% at 24 weeks. Temporary worsening in both subjective and objective parameters was observed only at 4 weeks; however, these parameters recovered to almost post-treatment levels at 24 weeks. Conclusion: The present study suggests that continuous treatment is not always needed to maintain urinary symptom relief in a specific subset of patients who felt symptom improvement after initial treatment with tamsulosin.

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Section: Resultscontrasting

confidence: 55%

Section: Resultsmentioning

confidence: 46%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Discontinuation of Tamsulosin Treatment in Men with Lower Urinary Tract Symptoms: A Pilot Study

2006

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“…[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.…”

mentioning

confidence: 99%

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

Burk¹,

Furmaga²,

Dong³

et al. 2004

JMCP

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amsulosin (Flomax) is described as a selective alpha (α) 1A -adrenergic antagonist (or blocker) that has been shown to improve lower urinary tract symptoms in patients with benign prostatic hyperplasia (BPH). [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. 22 Information from well-designed studies to support the use of tamsulosin in patients with BPH who have not responded to an adequate trial with terazosin, prazosin, or doxazosin is lacking.Tamsulosin differs from the other α-blockers in selectively blocking the α receptors in the genitourinary area with a minimal effect on the smooth muscle vasculature. Hence, the effect of tamsulosin on blood pressure is negligible. The incidence of orthostatic hypotension has been reported to be approximately 1% with tamsulosin (and alfuzosin, a clinically uroselective α-blocker) compared with 2% to 8% with terazosin or doxazosin in placebo-controlled studies. 22 Moreover, symptomatic postural hypotension has reportedly been lower with tamsulosin (3%) than with doxazosin (4%) and terazosin (6%, P<0.05). 23 In addition to being effective in patients with symptomatic BPH, the α-blockers-terazosin, prazosin, and doxazosin-are approved for the management of patients with hypertension. In contrast to the other α-blockers, tamsulosin is not indicated for the management of patients with hypertension. 24 A data collection form for medical record abstraction was designed to capture the patient's diagnosis, reported indication for tamsulosin, history of previous α-blocker use, tamsulosin follow-up evaluation, and the individual facility's method of implementation of criteria for nonformulary use. Patients receiving a prescription for tamsulosin during a 3-month period preceding the posting of national criteria, and patients with a first-time prescription for tamsulosin during a 3-month period after the national criteria were posted were randomly selected by the PBM and assigned for chart review at each site. T F O R M U L A RY M A N A G E M E N TRESULTS: Data for 332 patients were collected from 6 different sites over a 6-month period for each pregroup and postgroup beginning August 2001 and January 2002, respectively. Tamsulosin was prescribed for appropriate indications in 66% of patients, potentially appropriate indications in 4% of patients, and inappropriate indications in 30% of patients. Of the 206 patients (62%) who were prescribed tamsulosin as a result of a reported adverse event with a previous α-blocker, only 29% of the cases (N = 59) showed evidence that an attempt was made to reduce the dose of the first α-blocker to abate the side effects. Followup monitoring was conducted in 78% of tamsulosin patients, of whom 55% reported effectiveness of...

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Terazosin for benign prostatic hyperplasia

Wilt¹,

Howe²,

Rutks³

et al. 2000

The Cochrane Database of Systematic Reviews (Complete Reviews)

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Placebo‐controlled Study of Terazosin in the Treatment of Benign Prostatic Hyperplasia with 2‐Year Follow‐up

Cited by 22 publications

References 13 publications

Discontinuation of Tamsulosin Treatment in Men with Lower Urinary Tract Symptoms: A Pilot Study

Discontinuation of Tamsulosin Treatment in Men with Lower Urinary Tract Symptoms: A Pilot Study

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

Terazosin for benign prostatic hyperplasia

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