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Terazosin for BPH

 

Clinical bottom line

Terazosin was superior to placebo in improving flow rate and symptoms in men with BPH. There was no larger improvement with longer study duration, and there was a suggestion that better results occurred in men with prostates below 36 grams.


Reference

P Boyle et al. Meta-analysis of randomized trials of terazosin in the treatment of benign prostatic hyperplasia. Urology 2001 58: 717-722.

Review

Nine trials conducted since 1988 represented all randomised, double-blind trials of terazosin, and were supplied by the manufacturer. A Medline search found no additional trials.

Duration was 8 to 52 weeks. Four studies used a fixed dose (often 10 mg) and five used titration to response (2 to 10 mg).

Outcomes included prostate volume measured by TRUS, and changes in baseline of maximum urinary flow rate and urinary symptom scores.

Results

There were 3,948 men, with mean ages of 62 to 66 years in individual studies. Study withdrawals were up to 23% in the longer duration studies. Mean peak flow rate at baseline was 8.2 to 10.4 mL/second.

Flow rate

The overall estimated mean increased flow rate was 1.4 mL/second over what was seen with placebo. There was no obvious relationship with study duration.

Symptom score

The overall improvement on the AUA scale was a 3.5 point improvement over placebo, or 1.9 points on the Boyarsky scale.

Prostate volume as a predictor of response

There was a suggestion that a large prostate volume was associated with a lower response than in men with a smaller prostate volume. The highest response was in men with prostate volumes of below 36 grams.

Comment

Terazosin was superior to placebo.