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The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia
Journal article   Open access   Peer reviewed

The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia

John D Mcconnell, Claus G Roehrborn, E. David Crawford, Ananias Diokno, John P Foley, Harris E Foster, Stephen C Jacobs, Steven A Kaplan, Karl J Kreder, Michael M Lieber, …
The New England journal of medicine, Vol.349(25), pp.2387-2398
12/18/2003
DOI: 10.1056/NEJMoa030656
PMID: 14681504
url
https://doi.org/10.1056/NEJMoa030656View
Published (Version of record) Open Access

Abstract

BACKGROUND: Benign prostatic hyperplasia is commonly treated with alpha-adrenergic-receptor antagonists (alpha-blockers) or 5α-reductase inhibitors. The long-term effect of these drugs, singly or combined, on the risk of clinical progression is unknown. METHODS: We conducted a long-term, double-blind trial (mean follow-up, 4.5 years) involving 3047 men to compare the effects of placebo, doxazosin, finasteride, and combination therapy on measures of the clinical progression of benign prostatic hyperplasia. RESULTS: The risk of overall clinical progression - defined as an increase above base line of at least 4 points in the American Urological Association symptom score, acute urinary retention, urinary incontinence, renal insufficiency, or recurrent urinary tract infection - was significantly reduced by doxazosin (39 percent risk reduction, P≤0.001) and finasteride (34 percent risk reduction, P=0.002), as compared with placebo. The reduction in risk associated with combination therapy (66 percent for the comparison with placebo, P<0.001) was significantly greater than that associated with doxazosin (P<0.001) or finasteride (P<0.001) alone. The risks of acute urinary retention and the need for invasive therapy were significantly reduced by combination therapy (P<0.001) and finasteride (P<0.001) but not by doxazosin. Doxazosin (P<0.001), finasteride (P=0.001), and combination therapy (P<0.001) each resulted in significant improvement in symptom scores, with combination therapy being superior to both doxazosin (P=0.006) and finasteride (P[removed]
Biological and medical sciences Medical sciences Nephrology. Urinary tract diseases Tumors of the urinary system Urinary tract. Prostate gland

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