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Doxazosin Plus Finasteride Stalls Progression of BPH

ORLANDO, Florida (Reuters Health) May 29 - Results from the Medical Therapy of Prostatic Symptoms (MTOPS) Trial show that a combination therapy with doxazosin and finasteride slows the progression of signs and symptoms of benign prostatic hypertrophy (BPH) to a much greater extent than monotherapy alone.

Results of MTOPS were reported here Tuesday by Dr. John D. McConnell, of The University of Texas Southwestern Medical Center in Dallas, during proceedings of the 100th annual meeting of the American Urological Association.

In MTOPS, 3047 men diagnosed with BPH were randomized to placebo, doxazosin 4 mg or 8 mg, finasteride 5 mg, or doxazosin plus finasteride for approximately 5 years.

Combination therapy reduced the risk of urinary retention by 79%. Doxazosin alone reduced urinary retention risk by 31%, approximately equal to that of placebo, while finasteride alone reduced urinary retention by 67% during the 5-year study period. Risk of surgery for BPH was reduced 69% with combination therapy, by 64% with finasteride, and by 8% with doxazosin.

"We were somewhat surprised by the magnitude of the effect," Dr. McConnell told Reuters Health after his presentation. "The alpha-blocker (finasteride) slowed the symptoms, and the 5a-reductase inhibitor (doxazosin) slowed enlargement of the prostate," he said.

"It's two different drugs working toward the middle," rather than a synergistic effect, Dr. McConnell explained. "What was nice to see was that the side effects were no different with both drugs together. The combination of the drugs was greater than either drug alone."

Dr. McConnell said that candidates for dual therapy are men with enlarged prostates, increased PSA levels, and decreased urinary flow. Although the drugs work across the whole spectrum of BPH disease, they work best in patients with the highest risk factors "We aren't recommending it as preventative therapy, but if they have risk factors, these are the men who would benefit."


Reuters Health Information 2002. © 2002 Reuters Ltd

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