Long-term efficacy and safety of terazosin in patients with benign prostatic hyperplasia

Lepor, Herbert

doi:10.1016/s0090-4295(99)80008-9

Cited by 151 publications

(75 citation statements)

References 18 publications

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“…20,21 Two hundred and forty-®ve patients (7.6%) died during this three year study, which is consistent with the chance of dying (0.8% per 90 d) in a similar population of men. 11 The percentage of AEs leading to the discontinuation from the study is low (4.2%) as compared to that of a 42-month open trial conducted with terazosin in BPH patients (19%) 8 or a 48-month open trial conducted with doxazosin in normotensive and hypertensive BPH patients (15.1% and 19.1%, respectively.) 9 The percentages of patients (3.7%) operated on and experiencing acute urinary retention (0.3%) during this General Practice three-year follow-up were dramatically lower than in a watchful waiting study including symptomatic BPH patients reporting moderate symptoms followed-up in urological setting: 24% and 2.9%, respectively.…”

Section: Discussionmentioning

confidence: 98%

Three-year prospective study of 3228 clinical BPH patients treated with alfuzosin in General Practice

Lukacs

Grange

Comet

et al. 1998

Prostate Cancer Prostatic Dis

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Objectives: To investigate (a) the magnitude and durability of symptom score reduction and HRQL score improvement (including sexual drive); (b) adverse outcomes; and (c) progression to acute urinary retention and prostate surgery up to three years of treatment with alfuzosin.Methods: Three thousand two hundred and twenty-eight BPH-patients out of 812 centers were included in a prospective three-year open-labelled study and treated with alfuzosin (immediate release formulation) at the recommended dosage. A symptom score (Boyarsky modi®ed) and a 20-item BPH speci®c HRQL score including three questions of sexuality (Urolife TM BPH QoL 20) were selfadministered at baseline, 3,6,12,18,24,30, and 36 months.Results: Two thousand ®ve hundred and seventy-nine patients (79.9%) completed the study at the end of three years. Symptom score was signi®cantly reduced by 54% at 3 months and this reduction was maintained up to 36 months (748.4%); HRQL score was signi®cantly improved by 45.4% at 12 months and this improvement was maintained up to 36 months ( 43.4%). Alfuzosin was well tolerated: the quantitative and qualitative distribution of adverse events was similar to that previously observed in placebo-controlled studies (vertigo/dizziness: 2.1%). Adverse events accounted for 4.2% of the drop-outs. 120 patients (3.7%) were operated on for BPH and nine patients (0.3%) experienced acute urinary retention.Conclusion: This medical outcomes study con®rms the long-term safety pro®le of alfuzosin in the naturalistic conditions of general practice and highlights the need to measure HRQL in the context of patient's preferences.

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Section: Discussionmentioning

confidence: 98%

Three-year prospective study of 3228 clinical BPH patients treated with alfuzosin in General Practice

Lukacs

Grange

Comet

et al. 1998

Prostate Cancer Prostatic Dis

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“…[1][2][3][4][5][6][7] However, it is common for patients to never visit hospital to obtain prescriptions of drugs during follow up. 8 To evaluate the exact therapeutic role of a1-blockers for BPH/LUTS, prospective follow up of all intention-to-treat patients, including those who withdrew prematurely because of loss to follow up, is mandatory.…”

Section: Introductionmentioning

confidence: 99%

α1‐blocker tamsulosin as initial treatment for patients with benign prostatic hyperplasia: 5‐year outcome analysis of a prospective multicenter study

et al. 2012

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Abbreviations & AcronymsObjective: To comprehensively analyze the 5-year outcomes of tamsulosin treatment for patients with benign prostatic hyperplasia. Methods: Tamsulosin (0.2 mg/day) was given to 112 patients who had International Prostate Symptom Scores Ն8. They were prospectively followed for 5 years with periodic evaluation. If tamsulosin had to be discontinued, the reason was determined. Treatment failure was considered in the case of disease progression (postvoid residual urine volume Ն200 mL, acute urinary retention, febrile urinary tract infection or hydronephrosis as a result of bladder outlet obstruction), conversion to other a1-blockers or need for surgery. An intention-to-treat analysis was carried out. Results: A total of 34 patients (30.4%) continued the same medication for the overall study period, whereas 78 patients (69.6%) discontinued the medication. International Prostate Symptom Scores, Benign Prostatic Hyperplasia Problem Index and Quality of Life Index were significantly improved over the 5-year period. Treatment failure was observed in 21 patients (18.8%). Baseline prostate volume and postvoid residual urine volume were independent factors to predicting treatment failure. A total of 21 patients (18.8%) discontinued tamsulosin because of an improvement of symptoms. They were younger and had lower prostate-specific antigen levels than the remaining 91 patients. Their symptoms were stable even 1 year after termination of therapy. Conclusions: Long-term efficacy of tamsulosin was observed, although only a small portion of patients continued the treatment. a1-blocker monotherapy might be not appropriate for achieving a good long-term outcome in patients with a large prostate volume and a large amount of postvoid residual urine volume. Persistent improvement of symptoms, even after termination of tamsulosin, was observed in young patients with low prostate-specific antigen levels.

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“…Following earlier studies with the alkylating agent phenoxybenzamine (Caine et al, 1978), competitive a 1 -adrenoceptor antagonists such as terazosin (Lepor, 1995), prazosin (Hedlund et al, 1983;Chapple et al, 1992) and alfuzosin (Buzelin et al, 1993) have been shown to be e ective in relieving urinary out¯ow obstruction and reducing symptom scores in patients with benign prostatic hyperplasia (BPH). However, the usefulness of a 1 -adrenoceptor antagonists in BPH is o set by their dose-limiting cardiovascular e ects, including postural hypotension, particularly with initial dosing.…”

Section: Introductionmentioning

confidence: 99%

In vitroα₁‐adrenoceptor pharmacology of Ro 70–0004 and RS‐100329, novel α_1A‐adrenoceptor selective antagonists

Williams¹,

Blue²,

Daniels³

et al. 1999

British J Pharmacology

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Bank, She eld, ST10 2TN and 4 8 Palace Garden, Royston, Hertfordshire, S68 5AD1 It has been hypothesized that in patients with benign prostatic hyperplasia, selective antagonism of the a 1A -adrenoceptor-mediated contraction of lower urinary tract tissues may, via a selective relief of outlet obstruction, lead to an improvement in symptoms. 2 The present study describes the a 1 -adrenoceptor (a 1 -AR) subtype selectivities of two novel a 1 -AR antagonists, Ro 70-0004 (aka RS-100975) and a structurally-related compound RS-100329, and compares them with those of prazosin and tamsulosin. Radioligand binding and second-messenger studies in intact CHO-K1 cells expressing human cloned a 1A -, a 1B -and a 1D -AR showed nanomolar a nity and signi®cant a 1A -AR subtype selectivity for both Ro 70-0004 (pK i 8.9: 60 and 50 fold selectivity) and RS-100329 (pK i 9.6: 126 and 50 fold selectivity) over the a 1B -and a 1D -AR subtypes respectively. In contrast, prazosin and tamsulosin showed little subtype selectivity. 3 Noradrenaline-induced contractions of human lower urinary tract (LUT) tissues or rabbit bladder neck were competitively antagonized by Ro 70-0004 (pA 2 8.8 and 8.9), RS-100329 (pA 2 9.2 and 9.2), tamsulosin (pA 2 10.4 and 9.8) and prazosin (pA 2 8.7 and 8.3 respectively). A nity estimates for tamsulosin and prazosin in antagonizing a 1 -AR-mediated contractions of human renal artery (HRA) and rat aorta (RA) were similar to those observed in LUT tissues, whereas Ro 70-0004 and RS-100329 were approximately 100 fold less potent (pA 2 values of 6.8/6.8 and 7.3/7.9 in HRA/RA respectively). 4 The a 1A -AR subtype selectivity of Ro 70-0004 and RS-100329, demonstrated in both cloned and native systems, should allow for an evaluation of the clinical utility of a`uroselective' agent for the treatment of symptoms associated with benign prostatic hyperplasia.

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Long-term efficacy and safety of terazosin in patients with benign prostatic hyperplasia

Cited by 151 publications

References 18 publications

Three-year prospective study of 3228 clinical BPH patients treated with alfuzosin in General Practice

Three-year prospective study of 3228 clinical BPH patients treated with alfuzosin in General Practice

α1‐blocker tamsulosin as initial treatment for patients with benign prostatic hyperplasia: 5‐year outcome analysis of a prospective multicenter study

In vitroα₁‐adrenoceptor pharmacology of Ro 70–0004 and RS‐100329, novel α_1A‐adrenoceptor selective antagonists

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Long-term efficacy and safety of terazosin in patients with benign prostatic hyperplasia

Cited by 151 publications

References 18 publications

Three-year prospective study of 3228 clinical BPH patients treated with alfuzosin in General Practice

Three-year prospective study of 3228 clinical BPH patients treated with alfuzosin in General Practice

α1‐blocker tamsulosin as initial treatment for patients with benign prostatic hyperplasia: 5‐year outcome analysis of a prospective multicenter study

In vitroα1‐adrenoceptor pharmacology of Ro 70–0004 and RS‐100329, novel α1A‐adrenoceptor selective antagonists

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In vitroα₁‐adrenoceptor pharmacology of Ro 70–0004 and RS‐100329, novel α_1A‐adrenoceptor selective antagonists