Efficacy of Terazosin in Patients with
Benign Prostatic Hyperplasia

Matzkin, Haim; Ms, Soloway; Mc, Rangel; Laddu, Atul R.

doi:10.1159/000474817

Cited by 7 publications

(2 citation statements)

References 12 publications

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“…A description of these trials is provided in Table 1[10–26]. Reasons for trial exclusion included: not randomized, open‐label design [27–35]; not reporting primary or secondary efficacy outcomes data (e.g. BP or cardiovascular effects only) [36]; or pharmacokinetic studies [37].…”

Section: Methodsmentioning

confidence: 99%

Terazosin for treating symptomatic benign prostatic obstruction: a systematic review of efficacy and adverse effects

Wilt

Howe²,

MacDonald

2002

BJU International

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Objective To systematically review and evaluate the effectiveness and adverse effects of the a-antagonist, terazosin, for treating urinary symptoms associated with benign prostatic obstruction (BPO). Methods Studies were sought and included in the review if they were randomized trials of at least 1 month duration, involved men with symptomatic BPO and compared terazosin with placebo or active controls. The study, patient characteristics and outcome data were extracted in duplicate onto standardized forms using a prospectively developed protocol. Results Seventeen studies involving 5151 men met the inclusion criteria, i.e. placebo-controlled (10), ablockers (seven), ®nasteride alone or combined with terazosin and placebo (one), and microwave therapy (one). The study duration was 4±52 weeks; the mean age of the men was 65 years and 82% were white. Baseline urological symptom scale scores and¯ow rates showed that men had moderate BPO. Ef®cacy outcomes were rarely reported in a way that allowed for data pooling, but indicated that terazosin improved symptom scores and¯ow rates more than did placebo or ®nasteride, and similarly to other a-antagonists. The pooled mean percentage improvement for the Boyarsky symptom score was 37% for terazosin and 15% for placebo (four studies). The mean percentage improvement for the American Urological Association symptom score was 38%, compared with 17% and 20% for placebo and ®nasteride, respectively (two studies). The pooled mean improvement in the International Prostate Symptom Score of 40% was similar to that with tamsulosin (43%). Peak urinarȳ ow rates improved more with terazosin (22%) than with placebo (11%) and ®nasteride (15%), but did not differ signi®cantly from the other a-antagonists. The percentage of men discontinuing terazosin was comparable with those receiving placebo and ®nasteride, but greater than with other a-antagonists. Adverse effects were greater than with placebo and included dizziness, asthenia, headache and postural hypotension. Conclusions The available evidence indicates that terazosin improves the symptoms and¯ow rates associated with BPO; it was more effective than placebo or ®nasteride and similar to other aantagonists. Adverse effects were generally mild but more frequent than with other a-antagonists and associated with a two-to four-fold increase in treatment discontinuation.

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Section: Methodsmentioning

confidence: 99%

Terazosin for treating symptomatic benign prostatic obstruction: a systematic review of efficacy and adverse effects

Wilt

Howe²,

MacDonald

2002

BJU International

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“…The efficacy of oral terazosin 1 to 20mg once daily in the treatment of symptomatic benign prostatic hyperplasia has been demonstrated in several noncomparative short term studies (~6 months) [Cohen et al 1989;Dunzendorfer 1989;Fabricius et al 1990], and has been shown to be sustained in longer term (up to 2 years) noncomparative studies Matzkin et al 1992; data on file, Abbott Laboratories) [table II]. Efficacy has been reflected in statistically significant increases in peak (by 18 to 79% from baseline) urinary flow rate, and reductions in obstructive (32 to 74%) and irritative (8 to 51 %) symptom scores, and residual urinary volume (17 to 75%) from baseline.…”

Section: Noncomparative Studiesmentioning

confidence: 99%

Terazosin

Wilde¹,

Fitton²,

Sorkin³

1993

Drugs & Aging

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Terazosin selectively antagonises alpha 1-adrenoceptor-mediated contraction of the prostate, prostatic capsule, proximal urethra and bladder base, and consequently reduces urethral pressure, bladder outlet resistance and urinary symptoms associated with symptomatic benign prostatic hyperplasia. The efficacy of terazosin is reflected in increases in peak urinary flow rate, and reductions in obstructive and irritative symptom scores compared with placebo, and reductions in residual urinary volume from baseline. Clinical improvements begin to occur within 2 weeks and have been sustained for up to 2 years. The most marked treatment effects tend to occur in patients with more severe pretreatment urinary flow abnormalities. The relatively long duration of action of terazosin, allowing once-daily administration, offers a potential clinical advantage over other alpha 1-adrenoceptor antagonists although formal compliance studies have not been reported. Terazosin is generally well tolerated, but caution is recommended at treatment initiation and when dosage adjustments are made due to an increased risk of postural hypotension and related adverse effects at these times; such a risk has also been observed with several other alpha 1-adrenoceptor antagonists. Although publication of clinical trial results with terazosin is still evolving, this drug shows promise in the treatment of patients with mild to moderate symptomatic benign prostatic hyperplasia for whom surgery is not absolutely indicated. Terazosin also shows promise as a nonsurgical treatment alternative in patients with severe symptoms who are unfit for surgery and also in those who are on long waiting lists for surgery.

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