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

Lukacs, B.; Grange, J.C.; Comet, D.; McCarthy, Caitlin

doi:10.1038/sj.pcan.4500253

Cited by 35 publications

(13 citation statements)

References 22 publications

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“…30 This bene®t has been con®rmed in the three-year open study in 3228 patients in general practice, in which the incidence of AUR was only 0.3%. 31 Although there was no placebo arm, the incidence of AUR in this study was lower than the 2 ± 3% incidence reported in the literature for watchful waiting. 32 Alfuzosin has also been shown to favour return to a normal voiding pattern in a trial without catheter (TWOC) conducted in BPH patients with AUR.…”

Section: Bene®ts Of a A 1 -Blockers On Acute Urinary Retentioncontrasting

confidence: 45%

α1-Blocker therapy in the nineties: focus on the disease

Höfner

1999

Prostate Cancer Prostatic Dis

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Therapy for benign prostatic hyperplasia has evolved rapidly over the last decade, with the introduction in the early 1990s of new agents such as a 1 -blockers and 5a-reductase inhibitors. The major advantage of a 1 -blockers over 5a-reductase inhibitors is their rapid onset of action. Maximum¯ow rate is improved after ®rst administration and optimal symptom relief is usually reached within 2 ± 3 months. In addition, a 1 -blockers are effective regardless of prostate size and they provide a similar degree of symptom relief in patients with or without bladder outlet obstruction. The main adverse events with the a 1 -blockers relate to their effects on the cardiovascular system (postural hypotension) and central penetration (asthenia, somnolence). Newer uroselective a 1 -blockers, such as alfuzosin and tamsulosin, have a better safety pro®le and, as such, do not require initial dose titration. Alfuzosin has also been shown in a sixmonth study to signi®cantly reduce both residual urine and the incidence of acute urinary retention (AUR) compared with placebo. In addition, alfuzosin is effective in improving the success rate of a trial without catheter in patients with AUR.Keywords: benign prostatic hyperplasia; prostate; a 1 -blockers; 5a-reductase inhibitors; acute urinary retention; LUTS Management of BPHTherapy for benign prostatic hyperplasia (BPH) has evolved considerably over the past century. Performance of open prostatectomy, routine until 20 ± 25 years ago, has been gradually replaced by transurethral resection of the prostate (TURP), which is now the preferred surgical procedure worldwide. At the start of the 1990s, new therapies which were less interventional than TURP were introduced, such as thermotherapy, laser therapy and therapies involving radiofrequencies, e.g. transurethral needle ablation. To date, most of these techniques are still regarded as investigational and additional randomized studies focusing on costs and durability of symptomatic improvement are needed.The development of medical therapy for BPH has been a long process, beginning with phytotherapy in Egyptian times. In the mid-1970s, the better understanding of the pathophysiology of BPH led to the ®rst use of phenoxybenzamine, an irreversible antagonist of both a 1 /a 2 adrenoceptors. Medical management of BPH suddenly exploded at the beginning of the 1990s with the introduction of selective a 1 -blockers and 5a-reductase inhibitors.In terms of treatment goals for BPH, the two main objectives are to reduce symptoms and relieve obstruction. Obstruction and symptoms are not correlated, however, and patients may present with signi®cant symptoms but no obstruction. Consequently, it is important to distinguish between different patient types in order that the most appropriate treatment be given. TURPDramatic reduction in the use of TURP for the treatment of BPH worldwide have been reported, with perhaps the greatest decline in number of procedures being noted in the US (Figure 1). 1 TURP constituted 94% of all BPH surgery in 1995 in the US,...

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Section: Bene®ts Of a A 1 -Blockers On Acute Urinary Retentioncontrasting

confidence: 45%

α1-Blocker therapy in the nineties: focus on the disease

Höfner

1999

Prostate Cancer Prostatic Dis

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“…The long–term efficacy and safety of alfuzosin has been confirmed in large cohort studies with patients treated for up to 3 years [14, 15, 16]. The good safety profile of alfuzosin has been fully confirmed by post–marketing experience [17].…”

Section: Introductionmentioning

confidence: 75%

Efficacy and Safety of a New Prolonged Release Formulation of Alfuzosin 10 mg Once Daily versus Alfuzosin 2.5 mg Thrice Daily and Placebo in Patients with Symptomatic Benign Prostatic Hyperplasia

et al. 2000

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“…At 1-year follow-up, the mean Danish Prostate Symptom Score sexual function questionnaire scores showed signifi cant improvement in all of these symptoms, suggesting that alfuzosin is effi cacious in improving LUTS and may be effective in improving sexual function in patients with concomitant ED. These improvements in sexual function have been demonstrated in patients in up to 3 years of follow-up [18]. This apparent improvement in SD has not been noted with the other available α-blockers.…”

Section: Medical Therapymentioning

confidence: 66%