Concomitant Benign Prostatic Hyperplasia Research Articles

UP-03.26: What is effective and safe dose-raising method in patients with concomitant benign prostatic hyperplasia and hypertension after initial doxazosin 4mg: doxazosin 8mg versus combined therapy with doxazosin 4mg and tamsulosin 0.2mg

To compare the efficacy and safety of doxazosin 8mg with combined therapy with doxazosin 4mg and tamsulosin 0.2mg (permitted maximum dose by Korean medical insurance) in men with concomitant benign prostatic hyperplasia (BPH) and hypertension who have not achieved an adequate therapeutic response to doxazosin 4 mg (Cardura XL®). He (www.drugs.com) did not find any drug interactions between the following drugs: tamsulosin, doxazosin. There is no article about combined therapy of different alpha-blockers.

Efficacy of Extended-Release Doxazosin and Doxazosin Standard in Patients With Concomitant Benign Prostatic Hyperplasia and Sexual Dysfunction

Efficacy of Extended-Release Doxazosin and Doxazosin Standard in Patients With Concomitant Benign Prostatic Hyperplasia and Sexual Dysfunction

Efficacy of Extended-Release Doxazosin and Doxazosin Standard in Patients With Concomitant Benign Prostatic Hyperplasia and Sexual Dysfunction

No AccessJournal of UrologyUrological Survey: Benign Prostatic Hyperplasia1 Oct 2005Efficacy of Extended-Release Doxazosin and Doxazosin Standard in Patients With Concomitant Benign Prostatic Hyperplasia and Sexual Dysfunction Steven A. KaplanM.D. Steven A. KaplanSteven A. Kaplan More articles by this author View All Author Informationhttps://doi.org/10.1097/S0022-5347(01)68628-2AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Efficacy of Extended-Release Doxazosin and Doxazosin Standard in Patients With Concomitant Benign Prostatic Hyperplasia and Sexual Dysfunction." The Journal of Urology, 174(4 Part 1), p. 1353 References 1 : Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Eur Urol2003; 44: 637. Google Scholar 2 : The relationship between erectile dysfunction and lower urinary tract symptoms: epidemiological, clinical, and basic science evidence. Curr Urol Rep2004; 5: 251. Google Scholar © 2005 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 174Issue 4 Part 1October 2005Page: 1353 Advertisement Copyright & Permissions© 2005 by American Urological Association, Inc.MetricsAuthor Information Steven A. Kaplan More articles by this author Expand All Advertisement PDF DownloadLoading ...

1700: Efficacy of Extended-Release Doxazosin and Standard Doxazosin in Patients with Concomitant Benign Prostatic Hyperplasia and Sexual Dysfunction

1700: Efficacy of Extended-Release Doxazosin and Standard Doxazosin in Patients with Concomitant Benign Prostatic Hyperplasia and Sexual Dysfunction

Treatment of Benign Prostatic Hyperplasia in Hypertensive Men

As the proportion of the US population over the age of 65 continues to rise, it is likely that the number of individuals with concomitant benign prostatic hyperplasia and hypertension will also increase. To reduce morbidity and mortality, it is important to treat patients with hypertension optimally. Evidence from outcome trials suggests that alpha1 blockers should not be used as first-line antihypertensive therapy. Although some clinicians previously recommended alpha1 blocker monotherapy for patients with both hypertension and benign prostatic hyperplasia, the most recent American Urologic Association and Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure guidelines recommend independent treatment with the most appropriate pharmacologic agents for each condition. When treating patients with benign prostatic hyperplasia, clinicians should be aware of the potential impacts that alpha1 blockers may have on blood pressure and potential adverse events in patients who are normotensive as well as in patients with treated hypertension.

Efficacy of extended‐release doxazosin and doxazosin standard in patients with concomitant benign prostatic hyperplasia and sexual dysfunction

To report a comprehensive retrospective analysis of the favourable effects of doxazosin extended-release (XL) and doxazosin standard on the sexual health of patients with comorbid benign prostatic hyperplasia (BPH) and erectile dysfunction (ED), augmenting a previous study of 680 patients with symptomatic BPH. Men with BPH and aged 50-80 years participated in a randomized, double- blind, double-dummy, parallel-group, multicentre trial, completing a 2-week, single-blind, placebo run-in period before receiving doxazosin XL 4 or 8 mg once daily or doxazosin standard 1-8 mg once daily for 13 weeks. Baseline sexual function and changes from baseline after treatment with doxazosin were evaluated from responses of the International Index of Erectile Function (IIEF) questionnaire (with dysfunction defined as a score of < or = 3 for any question) and the five domains for erectile function (intercourse satisfaction, orgasmic function, sexual desire and overall sexual satisfaction). Of 680 patients randomized into the trial, 237 (35%) had ED at baseline; in these patients there were statistically and clinically significant improvements in each of the five IIEF domains with XL and standard doxazosin (P < or = 0.0019), with the range of improvement being from 13% to 41%. There were no significant differences between treatment groups. Doxazosin XL consistently improved sexual function, as assessed by the individual questions of the IIEF questionnaire. There was no statistically significant difference between groups for any sexual function question analysed. Doxazosin XL and standard improved sexual function in men with concomitant BPH and ED at baseline. This may represent an action independent of relieving lower urinary tract symptoms, because the beneficial effect of doxazosin was reported in patients with no symptomatic BPH.

Patients with uncontrolled hypertension or concomitant hypertension and benign prostatic hyperplasia.

At optimal doses, individual antihypertensive agents lower blood pressure (BP) by an average of 10 mmHg. Many patients with hypertension, including those with stage 3 hypertension, target organ damage, or those at high risk for cardiovascular events and/or adverse effects of high-dose monotherapy, are likely to require combination antihypertensive drug treatment to achieve the recommended systolic/diastolic BP (< 140/90 mmHg). Two studies, a placebo-controlled, double-blind trial (n = 70) and a community-based, open-label trial (n = 491) investigated the antihypertensive efficacy of doxazosin, a long-acting selective alpha1-adrenoceptor blocker, as add-on therapy for uncontrolled hypertension with other antihypertensive medications and in patients with concomitant benign prostatic hyperplasia (BPH) and treated but inadequately controlled hypertension, respectively. The addition of doxazosin to baseline antihypertensive medication(s) significantly lowered BP and had a significantly positive effect on the serum lipid profile. In patients with concomitant BPH, doxazosin significantly improved all BPH symptom scores, regardless of initial symptom severity. Add-on doxazosin sufficiently reduced systolic/diastolic BP such that many patients whose hypertension was previously uncontrolled by other antihypertensive medications were able to reach goal BP (< 140/90 mmHg). Doxazosin as add-on therapy was well tolerated. In conclusion, doxazosin as add-on therapy improves BP control in hypertensive patients not at goal BP and improves lower urinary tract symptoms in patients with concomitant BPH.

A randomized, double‐blind crossover study of tamsulosin and controlled‐release doxazosin in patients with benign prostatic hyperplasia

To compare the effects of the doxazosin gastrointestinal therapeutic system, extended-release (doxazosin-GITS) formulation, and tamsulosin, another alpha1-antagonist, on total International Prostate Symptom Score (IPSS) and maximum urinary flow rate (Qmax) in treating patients with benign prostatic hyperplasia (BPH). Data were analysed from a prospective, randomized, double-blind, crossover study of men aged 50-80 years with concomitant BPH and hypertension as inclusion criteria. Fifty-two men were treated in four phases: phase I, placebo run-in for 2 weeks; phase II, first study drug doxazosin-GITS or tamsulosin for 8 weeks; phase III, washout with placebo for 2 weeks; and phase IV, second study drug tamsulosin or doxazosin-GITS for 8 weeks. Doxazosin-GITS was started at 4 mg/day and tamsulosin at 0.4 mg/day, and then titrated to 8 mg/day and 0.8 mg/day, respectively, after 4 weeks of therapy if the increase in Qmax was < 3 mL/s or the reduction in total IPSS was < 30%. Efficacy assessments included the IPSS and Qmax. Changes in blood pressure were not analysed, as most patients were actually not hypertensive. Endpoint efficacy data were analysed using an analysis of covariance model, with terms for sequence, phase, patients and sequence within patients, in addition to the baseline as covariate. Forty-seven men were treated in both efficacy arms of the study and were evaluable for analysis. Doxazosin-GITS and tamsulosin significantly relieved lower urinary tract symptoms and significantly increased Qmax from baseline (P = 0.001). Doxazosin-GITS produced significantly greater improvements than tamsulosin in total IPSS (P = 0.019) and obstructive subscores (P = 0.004) at the last treatment visit. The difference between doxazosin-GITS and tamsulosin in improving Qmax approached significance in favour of the former (mean change from baseline 2.6 vs 1.7 mL/s, respectively; between-group difference P = 0.089). Both treatments were well tolerated. Treatment with doxazosin-GITS was significantly more effective than tamsulosin in relieving lower urinary tract symptoms.