Comparative efficacy of two α₁‐adrenoreceptor antagonists, doxazosin and alfuzosin, in patients with lower urinary tract symptoms from benign prostatic enlargement

Abstract

8.8 mg/day. The least squares mean ( SE ) change from baseline in total IPSS was -9.23 (0.6) for doxazosin and -7.45 (0.6) (both P < 0.001) for alfuzosin. The respective mean change from baseline in irritative symptoms was -3.5 (0.2) and -2.8 (0.3) (both P < 0.001). The differences between the treatment groups were statistically significant in favour of doxazosin (total IPSS, P = 0.036; irritative symptoms, P = 0.049). The improvement between groups was also significantly different for postvoid residual urine volume, at -29.19 (8.6) and +9.59 (8.9) mL for doxazosin and alfuzosin, respectively ( P = 0.002). Improvements in mean and maximum urinary flow rates were similar for both treatments, at +1.5 and +1.2, and +2.8 and +2.5 mL/s, respectively. Doxazosin and alfuzosin were both well tolerated, with most all-cause adverse events reported as mild or moderate. CONCLUSIONSThe mean doses of doxazosin and alfuzosin used in this study were not equipotent. Doxazosin 6.1 mg/day produced significantly greater improvements than alfuzosin 8.8 mg/day in total and irritative urinary symptom scores and postvoid residual urine volume in men with moderate to severe LUTS. Changes in maximum and mean flow rates were comparable. Doxazosin and alfuzosin were both well tolerated. KEYWORDSdoxazosin, alfuzosin, benign prostatic enlargement, lower urinary tract symptoms, efficacy OBJECTIVESTo compare doxazosin and alfuzosin in patients with moderate to severe lower urinary tract symptoms (LUTS) suggestive of bladder outlet obstruction. PATIENTS AND METHODSIn all, 210 men with LUTS were randomized to receive doxazosin 1-8 mg once daily or alfuzosin 5-10 mg divided in two or three daily doses in a 14-week, multicentre, double-blind, baseline-controlled, dose-titration study. The International Prostate Symptom Score (IPSS) and maximum urinary flow rate were used to assess the efficacy of the treatment.

Doxazosin in the treatment of benign prostatic hypertrophy: an update

“…(Rollema et al 1991; Christensen et al 1993; Janknegt and Chapple 1993; Chapple et al 1994; Fawzy et al 1995; Gillenwater et al 1995; Kaplan et al 1995; Roehrborn and Siegel 1996; Akan et al 1998; Andersen et al 2000; Kirby 2003; Kirby et al 2003; McConnell et al 2003; de Reijke and Klarskov 2004; Lee et al 2005). Two of the placebo-controlled trials had finasteride, a 5-alpha (5-α) reductase inhibitor, monotherapy, and combined doxazosin/finasteride (combination therapy) arms (Kirby et al 2003; McConnell et al 2003).…”

Controlled-release doxazosin in the treatment of benign prostatic hyperplasia

“…Although the main objective of this study was not to evaluate sexual Controlled-release doxazosin for BPH C Hernandez et al function by means of a specific questionnaire, it is important to note that only one nonserious treatmentrelated AE associated with sexual function was reported (one case of impotence). Unlike the AEs commonly reported in trials with other BPH therapies, such as erectile dysfunction and decreased libido with the 5a-reductase inhibitor finasteride 22 and abnormal ejaculation with some a-blockers, 23,24 doxazosin GITS for the treatment of BPH is associated with improvements in sexual function in BPH patients with concomitant sexual dysfunction. 25 These findings confirm the results of randomized controlled trials in BPH patients 13 ; however, the exclusion criteria for PSA X4 ng/ml and history of hypotension and orthostasis do favor a greater symptom improvement and reduced AE frequency than might be found in an unselected population.…”

Comparing the therapeutic outcome of different alpha-blocker treatments for BPH in the same individuals

“…Studies that compare various alpha-blockers have been carried out in patient groups with similar demographic characteristics [3][4][5]. However, the fact that drug bioavailability differs even within the same individual in different time frames [6] suggests that objective and subjective responses to alpha-blockers might actually be quite variable in studies comparing groups that are similar in terms of demographic characteristics.…”