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• W2017065464 abstract "No AccessJournal of UrologyAdult urology1 Jan 2006Combination Therapy With Doxazosin and Finasteride for Benign Prostatic Hyperplasia in Patients With Lower Urinary Tract Symptoms and a Baseline Total Prostate Volume of 25 Ml or Greater Steven A. Kaplan, John D. McConnell, Claus G. Roehrborn, Alan G. Meehan, Michael W. Lee, William R. Noble, John W. Kusek, Leroy M. Nyberg, and Medical Therapy of Prostatic Symptoms (MTOPS) Research Group † Steven A. KaplanSteven A. Kaplan Columbia University Medical Center, New York, New York More articles by this author , John D. McConnellJohn D. McConnell University of Texas Southwestern Medical Center at Dallas, Dallas, Texas More articles by this author , Claus G. RoehrbornClaus G. Roehrborn University of Texas Southwestern Medical Center at Dallas, Dallas, Texas More articles by this author , Alan G. MeehanAlan G. Meehan Merck Research Laboratories, Rahway, New Jersey More articles by this author , Michael W. LeeMichael W. Lee Merck Research Laboratories, Rahway, New Jersey More articles by this author , William R. NobleWilliam R. Noble George Washington University, Bethesda, Maryland More articles by this author , John W. KusekJohn W. Kusek National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland More articles by this author , Leroy M. NybergLeroy M. Nyberg National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland More articles by this author , and Medical Therapy of Prostatic Symptoms (MTOPS) Research Group † A complete list of MTOPS Research Group investigators has been published previously.1 More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)00041-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We examined data from the Medical Therapy of Prostatic Symptoms trial to determine the relationship between baseline TPV and the effect of medical therapy in men with LUTS secondary to BPH. Materials and Methods: A total of 3,047 patients with LUTS were randomized to placebo, 4 to 8 mg doxazosin, 5 mg finasteride or the combination of doxazosin and finasteride. Average treatment duration was 4.5 years The primary outcome was time to overall clinical progression of BPH, defined as a confirmed 4 point or greater increase in AUA SS, acute urinary retention, incontinence, renal insufficiency or recurrent urinary tract infection. Secondary outcomes were the need for invasive therapy for BPH, and changes in AUA SS and the maximum urinary flow rate with time. TPV was measured by transrectal ultrasound at baseline and study end. Results: In patients with a small prostate (baseline TPV less than 25 ml) combination therapy was no better than doxazosin alone for decreasing the risk of clinical progression of BPH and need for invasive therapy as well as improving AUA SS and the maximum urinary flow rate. However, in patients with moderate size (25 to less than 40 ml) or enlarged (40 ml or greater) glands combination therapy led to a clinical benefit in these outcomes that was superior to that of doxazosin or finasteride. Conclusions: Combination therapy with doxazosin and finasteride led to a greater decrease in the risk of clinical progression of BPH than either drug alone in patients with LUTS with a baseline TPV of 25 ml or greater. References 1 : The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med2003; 349: 2387. Google Scholar 2 : AUA guideline on management of benign prostatic hyperplasia (2003). Chapter 1: Diagnosis and treatment recommendations. J Urol2003; 170: 530. Link, Google Scholar 3 : Study design of the Medical Therapy of Prostatic Symptoms (MTOPS) trial. Control Clin Trials2003; 24: 224. Google Scholar © 2006 by American Urological AssociationFiguresReferencesRelatedDetailsCited bySharkey C, Long X, Wang Z, Al-Faouri R, Gershman B, Tsai L and Olumi A (2021) Zonal Growth Pattern of the Prostate Is Affected by Age and Body Mass IndexJournal of Urology, VOL. 207, NO. 4, (876-884), Online publication date: 1-Apr-2022.Zhang H, Frendl D, Wang Z and Olumi A (2020) High Real-World Medication Adherence and Durable Clinical Benefit in Medicare Patients Treated with 5-Alpha Reductase Inhibitors for Benign Prostatic HyperplasiaJournal of Urology, VOL. 204, NO. 2, (325-331), Online publication date: 1-Aug-2020.Kaplan S, Lee J, Meehan A and Kusek J (2011) Long-Term Treatment With Finasteride Improves Clinical Progression of Benign Prostatic Hyperplasia in Men With an Enlarged Versus a Smaller Prostate: Data From the MTOPS TrialJournal of Urology, VOL. 185, NO. 4, (1369-1373), Online publication date: 1-Apr-2011.Loeb S, Kettermann A, Carter H, Ferrucci L, Metter E and Walsh P (2009) Prostate Volume Changes Over Time: Results From the Baltimore Longitudinal Study of AgingJournal of Urology, VOL. 182, NO. 4, (1458-1462), Online publication date: 1-Oct-2009.Kramer B, Hagerty K, Justman S, Somerfield M, Albertsen P, Blot W, Carter H, Costantino J, Epstein J, Godley P, Harris R, Wilt T, Wittes J, Zon R and Schellhammer P (2009) Use of 5α-Reductase Inhibitors for Prostate Cancer Chemoprevention: American Society of Clinical Oncology/American Urological Association 2008 Clinical Practice GuidelineJournal of Urology, VOL. 181, NO. 4, (1642-1657), Online publication date: 1-Apr-2009.Roehrborn C, Siami P, Barkin J, Damião R, Major-Walker K, Morrill B and Montorsi F (2007) The Effects of Dutasteride, Tamsulosin and Combination Therapy on Lower Urinary Tract Symptoms in Men With Benign Prostatic Hyperplasia and Prostatic Enlargement: 2-Year Results From the CombAT StudyJournal of Urology, VOL. 179, NO. 2, (616-621), Online publication date: 1-Feb-2008.Weiss J (2007) Editorial CommentJournal of Urology, VOL. 178, NO. 5, (2050-2051), Online publication date: 1-Nov-2007.Kaplan S (2007) Benign Prostatic HyperplasiaJournal of Urology, VOL. 178, NO. 2, (586-589), Online publication date: 1-Aug-2007. Volume 175Issue 1January 2006Page: 217-220 Advertisement Copyright & Permissions© 2006 by American Urological AssociationKeywordsdoxazosinfinasteridelower urinary tract symptomsprostatecombination therapyprostatic hyperplasiaAcknowledgmentDrug products were provided by Merck and Pfizer.MetricsAuthor Information Steven A. Kaplan Columbia University Medical Center, New York, New York More articles by this author John D. McConnell University of Texas Southwestern Medical Center at Dallas, Dallas, Texas More articles by this author Claus G. Roehrborn University of Texas Southwestern Medical Center at Dallas, Dallas, Texas More articles by this author Alan G. Meehan Merck Research Laboratories, Rahway, New Jersey More articles by this author Michael W. Lee Merck Research Laboratories, Rahway, New Jersey More articles by this author William R. Noble George Washington University, Bethesda, Maryland More articles by this author John W. Kusek National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland More articles by this author Leroy M. Nyberg National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland More articles by this author Medical Therapy of Prostatic Symptoms (MTOPS) Research Group † A complete list of MTOPS Research Group investigators has been published previously.1 More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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