A multicenter, randomized, double-blind, placebo-controlled study to evaluate the safety and efficacy of terazosin in the treatment of benign prostatic hyperplasia.

OBJECTIVES This study was designed to evaluate the safety and efficacy of the selective alpha 1-adrenoceptor blocker terazosin in the treatment of benign prostatic hyperplasia (BPH). METHODS Two hundred twenty-four patients aged 50 to 80 years, who had a diagnosis of BPH based on medical history, physical examination, and digital palpation, were recruited from 11 different sites between January 1992 and January 1994. The study consisted of a screening phase, a placebo phase, a double-blind dose-titration phase, and a double-blind maintenance phase. RESULTS Of the patients recruited, 164 entered the double-blind phase and of these 134 were evaluable. Only 11 patients withdrew because of an adverse event, 7 in the terazosin and 4 in the placebo group. Compared to placebo, terazosin significantly increased peak and mean urine flow rates without significantly affecting voided volume or postvoid residual volume. It significantly improved both the obstructive and irritative symptoms associated with BPH. Fifty-one patients from the terazosin group reported a total of 120 adverse events compared with 83 reported by 42 patients in the placebo group. The majority of these events were mild to moderate. Seventeen terazosin-treated patients reported hypotension-related adverse events and 4 withdrew from the study. However, concurrent treatment with antihypertensive agents did not affect the blood pressure response of the terazosin group. CONCLUSIONS Overall, this study showed terazosin to be safe and effective in relieving the signs and symptoms of BPH and should be considered as a treatment alternative.

[1]  H. Lepor,et al.  The efficacy and safety of terazosin for the treatment of symptomatic BPH , 1991, The Prostate.

[2]  S. Meretyk,et al.  A placebo-controlled double-blind study of the effect of phenoxybenzamine in benign prostatic obstruction. , 1978, British journal of urology.

[3]  M. Soloway,et al.  Efficacy of terazosin in patients with benign prostatic hyperplasia. , 1992, European urology.

[4]  H. Lepor,et al.  The relative efficacy of terazosin versus terazosin and flutamide for the treatment of symptomatic BPH , 1992, The Prostate.

[5]  P. G. Fabricius,et al.  Placebo-controlled study of terazosin in the treatment of benign prostatic hyperplasia with 2-year follow-up. , 1992, British journal of urology.

[6]  G Jones,et al.  A new look at bladder neck obstruction by the food and drug administration regulators: guide lines for investigation of benign prostatic hypertrophy. , 1976, Transactions of the American Association of Genito-Urinary Surgeons.

[7]  H. Lepor,et al.  The safety, efficacy and compliance of terazosin therapy for benign prostatic hyperplasia. , 1992, The Journal of urology.

[8]  H. Lepor,et al.  A randomized, placebo-controlled multicenter study of the efficacy and safety of terazosin in the treatment of benign prostatic hyperplasia. , 1992, The Journal of urology.

[9]  H. Lepor,et al.  Terazosin in the treatment of benign prostatic hyperplasia: the United States experience. , 1992, British journal of urology.

[10]  N. Roos,et al.  Use of claims data systems to evaluate health care outcomes. Mortality and reoperation following prostatectomy. , 1987, JAMA.

[11]  M. Caine,et al.  The use of alpha-adrenergic blockers in benign prostatic obstruction. , 1976, British journal of urology.

[12]  D. McTavish,et al.  Alfuzosin. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in benign prostatic hyperplasia. , 1993, Drugs.

[13]  U. Dunzendorfer,et al.  Efficacy of once‐A‐day terazosin in benign prostatic hyperplasia: A randomized, double‐blind placebo‐controlled clinical trial , 1990, The Prostate. Supplement.

[14]  E. Vaughan,et al.  Medical management of benign prostatic hyperplasia. , 1990, Urology.

[15]  A T Cockett,et al.  Transurethral prostatectomy: practice aspects of the dominant operation in American urology. , 1989, The Journal of urology.

[16]  F. Di Silverio,et al.  Use of terazosin in the medical treatment of benign prostatic hyperplasia: experience in Italy. , 1992 .

[17]  R Guthrie Terazosin in the treatment of hypertension and symptomatic benign prostatic hyperplasia: a primary care trial. , 1994, The Journal of family practice.

[18]  P. Walsh,et al.  The development of human benign prostatic hyperplasia with age. , 1984, The Journal of urology.

[19]  S. Raz,et al.  Adrenergic and cholinergic receptors in the human prostate, prostatic capsule and bladder neck. , 1975, British journal of urology.

[20]  C P Chilton,et al.  Terazosin in the treatment of benign prostatic hyperplasia: a multicentre, placebo-controlled trial. , 1992, British journal of urology.

[21]  R. Kirby,et al.  Prazosin in the treatment of prostatic obstruction. A placebo-controlled study. , 1987, British journal of urology.

[22]  K. Andersson,et al.  Effects of prazosin in patients with benign prostatic obstruction. , 1983, The Journal of urology.

[23]  H. Lepor,et al.  The efficacy of transurethral resection of the prostate in men with moderate symptoms of prostatism. , 1990, The Journal of urology.

[24]  M. Brawer,et al.  Terazosin in the treatment of benign prostatic hyperplasia. Terazosin Benign Prostatic Hyperplasia Study Group. , 1993, Archives of family medicine.

[25]  A. Fitton,et al.  Terazosin. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in benign prostatic hyperplasia. , 1993, Drugs & aging.

[26]  D. Gleason,et al.  Effect of terazosin on urine storage and voiding in the aging male with prostatism , 1994, Neurourology and urodynamics.

[27]  M. Barry,et al.  The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. , 1992, The Journal of urology.