Tamsulosin Versus Terazosin for Benign Prostatic Hyperplasia: A Systematic Review

Dong, Zhilong; Wang, Zhiping; Yang, Kehu; Liu, Yali; Gao, Wenhui; Chen, Wenyuan

doi:10.3109/19396360902833235

Cited by 24 publications

(4 citation statements)

References 25 publications

(20 reference statements)

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“…Terazosin: Regarding BPH management, one alternative to discontinuing terazosin would be to consider switching it to tamsulosin as fewer patients experienced dizziness [relative risk (RR) 0.38 95% CI: 0.30, 0.48] and severe hypotension (RR 0.16, 95% CI: 0.04, 0.68) compared to patients taking terazosin. 55 NSAIDS: The NSAID use and risk for worsening kidney function requires consideration of alternative agents (e.g., acetaminophen).…”

Section: Discussion Points For Specific Medications Considered For Deprescribingmentioning

confidence: 99%

“…Our clinical vignette illustrates medication targets for less inappropriate prescribing (Figure 1). 51,55,56…”

Section: Less Inappropriate Prescribing Of Medicationsmentioning

confidence: 99%

“…Thus, if polypharmacy is concomitant with substantial pill burden or side effects, medications with little benefit should be considered for deprescribing (54). Our clinical vignette illustrates medication targets for less inappropriate prescribing (Figure 1) (51,55,56).…”

Section: Less Inappropriate Prescribing Of Medicationsmentioning

confidence: 99%

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Less is More: Deprescribing Medications in Older Adults with Kidney Disease: A Review

Mohottige

Manley²,

Hall

2021

Kidney360

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Due to both age and impaired kidney function, older adults with kidney disease are at increased risk of medication-related problems and related hospitalizations. One proactive approach to minimize this risk is deprescribing. Deprescribing refers to the systematic process of reducing or stopping a medication. Aside from preventing harm, deprescribing can potentially optimize patients' quality of life by aligning medications with their goals of care. For some patients, deprescribing could involve less aggressive management of their diabetes and/or hypertension. In other instances, deprescribing targets may include potentially inappropriate medications that carry greater risk of harm than benefit in older adults, medications that have questionable efficacy, including medications that have varying efficacy by degree of kidney function, and that increase medication regimen complexity. We include a guide for clinicians to utilize in deprescribing, the List, Evaluate, Shared Decision-Making, Support (LESS) framework. The LESS framework provides key considerations at each step of the deprescribing process that can be tailored for the medications and context of individual patients. Patient characteristics or clinical events that warrant consideration of deprescribing include limited life expectancy, cognitive impairment, and health status changes, such as dialysis initiation or recent hospitalization. We acknowledge patient, clinician, and system-level challenges to the deprescribing process. These include patient hesitancy and challenges to discussing goals of care, clinician time constraints and a lack of evidence-based guidelines, as well as system-level challenges of interoperable electronic health records and limited incentives for deprescribing. However, novel evidence-based tools designed to facilitate deprescribing and future evidence on effectiveness of deprescribing could help mitigate these barriers. This review provides foundational knowledge on deprescribing as an emerging component of clinical practice and research within nephrology.

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Section: Discussion Points For Specific Medications Considered For Deprescribingmentioning

confidence: 99%

“…Our clinical vignette illustrates medication targets for less inappropriate prescribing (Figure 1). 51,55,56…”

Section: Less Inappropriate Prescribing Of Medicationsmentioning

confidence: 99%

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Less is More: Deprescribing Medications in Older Adults with Kidney Disease: A Review

Mohottige

Manley²,

Hall

2021

Kidney360

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“…19 DLB is a disease of aging and disproportionality affects men, 20 yielding an alignment between the people at highest risk of DLB and the primary users of these medications. Of importance, tamsulosin, another α-1 blocker, has similar clinical indications and effectiveness 21 but neither binds to PGK1 nor increases ATP. These features make tamsulosin an ideal active comparator-the observational approximation of a placebo-because men taking tamsulosin or Tz/ Dz/Az are likely similar on many observed and unobserved characteristics, but tamsulosin is not expected to have any effect on PGK1.…”

Section: Introductionmentioning

confidence: 99%

Association of Terazosin, Doxazosin, or Alfuzosin Use and Risk of Dementia With Lewy Bodies in Men

Hart,

Aldridge,

Zhang

et al. 2024

Neurology

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Background and ObjectivesTerazosin, doxazosin, and alfuzosin (Tz/Dz/Az) are α-1 adrenergic receptor antagonists that also bind to and activate a key adenosine triphosphate (ATP)-producing enzyme in glycolysis. It is hypothesized that the increase in energy availability in the brain may slow or prevent neurodegeneration, potentially by reducing the accumulation of alpha-synuclein. Recent work has suggested a potentially neuroprotective effect of the use of Tz/Dz/Az in Parkinson disease in both animal and human studies. We investigated the neuroprotective effects of Tz/Dz/Az in a closely related disease, dementia with Lewy bodies (DLB). MethodsWe used a new-user active comparator design in the Merative Marketscan database to identify men with no history of DLB who were newly started on Tz/Dz/Az or 2 comparator medications. Our comparator medications were other drugs commonly used to treat benign prostatic hyperplasia that do not increase ATP: the α-1 adrenergic receptor antagonist tamsulosin or 5α-reductase inhibitor (5ARI). We matched the cohorts on propensity scores and duration of follow-up. We followed up the matched cohorts forward to estimate the hazard of developing DLB using Cox proportional hazards regression. ResultsMen who were newly started on Tz/Dz/Az had a lower hazard of developing DLB than matched men taking tamsulosin (n = 242,716, 728, hazard ratio [HR] 0.60, 95% CI 0.50-0.71) or 5ARI (n = 130,872, 399,316 person-years, HR 0.73, 95% CI 0.57-0.93). while the hazard in men taking tamsulosin was similar to that of men taking 5ARI (n = 159,596, 482,280 person-years, HR 1.17, 95% CI 0.96-1.42). These results were robust to several sensitivity analyses. DiscussionWe find an association in men who are taking Tz/Dz/Az and a lower hazard of DLB compared with similar men taking other medications. When combined with the literature of Tz/Dz/Az on Parkinson disease, our findings suggest that glycolysis-enhancing drugs may be broadly protective in neurodegenerative synucleinopathies. A future randomized trial is required to assess these associations for causality. Classification of EvidenceThis study provides Class III evidence that Tz/Dz/Az use reduces the rate of developing DLB in adult men.

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Benign Surgical Conditions

Thirugnanasundralingam

Tasevski

Lawrentschuk

2022

Men’s Health and Wellbeing

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Tamsulosin Versus Terazosin for Benign Prostatic Hyperplasia: A Systematic Review

Cited by 24 publications

References 25 publications

Less is More: Deprescribing Medications in Older Adults with Kidney Disease: A Review

Less is More: Deprescribing Medications in Older Adults with Kidney Disease: A Review

Association of Terazosin, Doxazosin, or Alfuzosin Use and Risk of Dementia With Lewy Bodies in Men

Benign Surgical Conditions

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