Efficacy and tolerability of doxazosin and finasteride, alone or in combination, in treatment of symptomatic benign prostatic hyperplasia: the Prospective European Doxazosin and Combination Therapy (PREDICT) trial

Kirby, Roger; Roehrborn, Claus G.; Boyle, Peter; Bartsch, Georg; Jardin, A; Cary, Margaret M; Sweeney, Michael; Grossman, E.

doi:10.1016/s0090-4295(02)02114-3

Cited by 334 publications

(261 citation statements)

References 16 publications

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“…Previous studies with other a 1 -AR antagonists, such as the Veterans Affairs (VA), ALFIN and Prospective European Doxazosin and Combination Therapy (PREDICT) trials, failed to demonstrate additional efficacy with the combination of these two classes of drugs. [10][11][12] Therefore, at variance with the design of the mentioned studies, a combination arm was not included in the MICTUS study. Owing to the low acceptance by European investigators, patients and Ethical Committees of a long-term study with placebo and in line with the European study comparing alfuzosin and finasteride, a placebo group was also not included.…”

Section: Discussionmentioning

confidence: 99%

“…20 As already indicated, our study did not include a combination arm of tamsulosin and finasteride as the VA, ALFIN and PREDICT study did not show an advantage of this treatment over monotherapy with an a 1 -AR antagonist after up to 1 y of treatment. [10][11][12] Recently, the results of the landmark Medical Therapy Of Prostatic Symptoms (MTOPS) trial, a placebo-controlled study comparing the a 1 -AR antagonist doxazosin, finasteride and their combination in 3047 LUTS/BPH patients with a mean follow-up of 5 y, became available. 21,22 These results indicate that, in the long term, combination therapy is statistically significantly more effective than both monotherapies, in improving urinary symptoms (total I-PSS) and reducing clinical progression.…”

Section: Discussionmentioning

confidence: 99%

“…9 Several direct comparative trials have compared the efficacy and tolerability of an a 1 -AR antagonist and finasteride. [10][11][12] Finasteride has been shown to be less effective than alfuzosin, doxazosin and terazosin in relieving LUTS/BPH. So far, tamsulosin has never been directly compared with finasteride in the treatment of LUTS/BPH.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A comparison of the efficacy and tolerability of tamsulosin and finasteride in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia

Rigatti

Brausi

Scarpa

et al. 2003

Prostate Cancer Prostatic Dis

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In this multicentre, double-blind study, patients with LUTS/BPH were randomised to 26 weeks with finasteride 5 mg once daily (n ¼ 204) or tamsulosin 0.4 mg once daily (n ¼ 199). Double-blind treatment was continued for another 26 weeks (total treatment duration: 1 y). The primary efficacy parameter was the difference in mean change in total Symptom Problem Index (SPI) from baseline to end point at week-26 in the intention-to-treat (ITT) and per protocol (PP) populations. Tamsulosin induced a greater improvement in total SPI (À5.2 points or À37%) compared to finasteride (À4.5 points or À31%) at week-26 (P ¼ 0.055 in ITT and P ¼ 0.032 in PP). Tamsulosin improved urinary symptoms (particularly the more bothersome storage symptoms) and flow more quickly than finasteride. The difference was statistically significant for the SPI from week-1 (reduction, respectively, À2.5 vs À1.8 points, P ¼ 0.043) to week-18 and for Q max from week-1 (increase, respectively, 2.3 vs 0.7 ml/s, P ¼ 0.0007) to week-12. Both treatments were well tolerated with a comparable incidence of adverse events, including urinary retention.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A comparison of the efficacy and tolerability of tamsulosin and finasteride in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia

Rigatti

Brausi

Scarpa

et al. 2003

Prostate Cancer Prostatic Dis

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“…[58,59] In these trials, a combination of finasteride and terazosin and that of finasteride and doxazosin were evaluated in BPH patients over a period of 12 months. In both the trials, the combination therapy was found to be no more effective than the use of alpha-adrenergic blockers alone.…”

Section: Combination Of 5α-reductase Inhibitors and Alpha-adrenergic mentioning

confidence: 99%

Current status of 5α-reductase inhibitors in the treatment of benign hyperplasia of prostate

Kumar¹,

Wahane²

2008

Indian J Med Sci

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Benign prostatic hyperplasia (BPH) is a common problem in aging menof BPH include increased urinary frequency, urgency, intermittency; nocturia; decreased force of stream; hesitancy and straining that are usually associated with complications such as acute urinary retention, urinary incontinence, recurrent urinary tract infection, hematuria, renal failure, and bladder stone. [4][5][6][7][8][9] The primary goal for treating symptomatic BPH is to improve urine ß ow, for which both surgical and nonsurgical approaches are available. Surgical treatment for BPH is usually indicated in recurrent cases of urinary retention, urinary tract infections, hematuria, and in azotemia.

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“…Bu durum kombine tedavi arayışlarını arttırmıştır. 1990'lı yıllara kadar 5 alfa redüktaz inhibitörlerinin alfa blokör tedavi ile kombinasyonun monoterapiye belirgin bir üstünlüğünün olmadığı belirtilirken daha sonra yapılan önemli bazı çalışmalardan sonra günümüzde AUA ve EAU klavuzlarında önerilen bir tedavi halini almıştır (13).…”

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Effects of Tolterodine and Tamsulosin Combination on Sypmtoms and Bladder Outlet Obstruction in Patients with Benign Prostate Hyperplasia

Güzel¹

2013

J Turgut Ozal Med Cent

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ÖzetAmaç: Çalışmanın amacı tamsulosin, tolterodin monoterapisi ile kombinasyon tedavisinin benign prostat hiperplazisinde semptomatik ve ürodinamik açıdan kaşılaştırılmasıdır. Gereç ve Yöntemler: Benign prostat hiperplazisine bağlı alt üriner sistem semptomları olan 66 erkek hasta tamsulosin, tolterodin ve tolterodin+tamsulosin olarak üç gruba ayrıldı. Tedavi öncesi ve sonrası yaş, prostat spesifik antijen, prostat hacimleri, "international prostate symptom scor" değerleri belirlendi. Basınç akım çalışması ile Qmax, PdetQmax, sistometrik mesane kapasiteleri ve detrüsör aşırı aktivitesi, rezidüel idrar miktarı, Abrams-Griffith obstrüksiyon skorları (ObstInd) saptandı. Altı ay süre ile birinci gruptaki hastalara tolterodin günde iki kez 2 mg, ikinci gruptaki hastalara tamsulosin günde bir kez 0.4 mg ve üçüncü gruptakilere her iki preparat aynı dozlarda kombinasyon olarak verildi. Tedavi sonrası "international prostate symptom score", ve basınç-akım çalışması tekrarlandı. Elde edilen değişimler her grup kendi içinde ve gruplar arasında karşılaştırıldı. Bulgular: Tolterodin grubunda rezidüel idrar miktarında istatistiksel anlamlı değişiklik saptanmadı ancak tamsulosin ve kombinasyon gruplarında rezidüel idrar miktarı anlamlı olarak azaldı. Qmax, PdetQmax, sistometrik kapasite, Abrams-Griffith obstrüksiyon skorları tolterodin ve tamsulosin gruplarında anlamlı olarak değişmez iken kombinasyon grubunda anlamlı düzeyde iyileşme saptandı. Tamsulosin grubu, "international prostate symptom score -total", "international prostate symptom score -obstrüktif", Vr, PdetQmax ve ObstInd de kombinasyon grubu ile benzer etkinlik gösterirken, kombine tedavi international prostate symptom score irritatif alt skorunda ve noktüri sayısında her iki gruptan daha etkindi. Sonuç: Benign prostat hiperplazisine bağlı alt üriner sistem semptomlarından aşırı aktif mesane semptomu olan ve alfa blokör tedaviden fayda görmeyen hastaların kombine tedaviden fayda göreceğini düşünmekteyiz. Anahtar Kelimeler: Alt Üriner Sistem Semptomları; Benign Prostat Hiperplazisi; Antikolinerjik Tedavi. Effects of Tolterodine and Tamsulosin Combination on Sypmtoms and Bladder Outlet Obstruction in Patients with Benign Prostate HyperplasiaAbstract Aim: To compare the symptomatic and urodynamic aspects of mono-therapies and combination therapies of tolterodine and tamsulosin. Meterial and Methods: Sixty-six patients with lower urinary tract symptoms due to benign prostatic hyperplasia were separated into three treatment groups as tolterodine only group, tamsulosin mono-therapy group, and tolterodine+tamsulosin combination therapy group. Demographics of the patients were noted and prostate specific antigen, prostate volumes, and international prostate symptom scores were determined before and after the treatment. Qmax, PdetQmax, cystometric bladder capacities and detrusor hyperactivities, residual urine portions, Abrams-Griffith obstruction scores (ObstInd) were established. Patients took 2 mg of tolterodine twice a day in first group, 0.4 mg of tamsulosine once a da...

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Efficacy and tolerability of doxazosin and finasteride, alone or in combination, in treatment of symptomatic benign prostatic hyperplasia: the Prospective European Doxazosin and Combination Therapy (PREDICT) trial

Cited by 334 publications

References 16 publications

A comparison of the efficacy and tolerability of tamsulosin and finasteride in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia

A comparison of the efficacy and tolerability of tamsulosin and finasteride in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia

Current status of 5α-reductase inhibitors in the treatment of benign hyperplasia of prostate

Effects of Tolterodine and Tamsulosin Combination on Sypmtoms and Bladder Outlet Obstruction in Patients with Benign Prostate Hyperplasia

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