Clinical Experience of Symptomatic Management of BPH with Terazosin, Doxazosin or Combination of Terazosin and Finasteride

Jeong, Dong Hwi; Park, Yong Il

Abstract

PURPOSE: We evaluated and compared the efficacy of terazosin, doxazosin and terazosin(alpha-1 adrenoreceptor antagonist) with finasteride(5-alpha reductase inhibitor) in the treatment of patient with benign prostatic hyperplasia (BPH).
MATERIALS AND METHODS
The study was single-blind design. The patients were divided 3 groups(terazosin group, doxazosin group, terazosin with finasteride group). Terazosin was administrated with escalating dose of 1 to 5mg once daily for 12 weeks. Doxasosin, fixed dose of 2mg was taken once daily for 12 weeks. Finasteride was taken 5mg once daily with terazosin for 12 weeks. The study enrolled 69 patients, and 60 patients were included in the analyses.
RESULTS
The parameters used to assess the effectiveness included international Prostatic Symptom Score(1-PSS), Quality of Life(QOL) index and peak urinary flow rate(Qmax). At baseline, 1-PSS, QOL index and Qmax were 18.8+/-4.3, 3.7+/-1.0, 8.6+/-1.7 in terazosin group, 19.3+/-3.9, 3.6+/-1.0, 7.8+/-1.8 in doxazosin group, 20.1+/-4.4, 3.8+/-1.0, 72 +/-1.6 in combination group, respectively. After 12 weeks trial, 1-PSS, QOL index and Qmax were 12.0+/-2.8, 1.9+/-0.9, 11.4+/-2.8 respectively in terazosin group, 11.3+/-3.0, 1.7+/- 0.7, 10.6+/-2.6 in doxazosin group, 10.9+/-4.0, 1.8+/-0.9, 9.8+/-1.0 in combination group, respectively.
CONCLUSIONS
There was clear evidence for the efficacy of alpha-1 blocker in treating patients with bladder outlet obstruction due to BPH. There was no significant difference between alpha-1 blocker therapy alone and combination therapy with finasteride. This study showed beneficial short term results for the safety and efficacy of long acting selective alpha-1 blocker and finasteride in the management of symptomatic BPH, but if symptom and quality of life for patient were not improved, we are 1ikely to consider that early surgical therapy will be required.