Key result
Doxazosin shows similar effectiveness to terazosin for improving LUTS.
Why the study?
Does doxazosin compared to terazosin improve IPSS and Qmax in male patients with LUTS suggestive of BPH?
RCT (n=50)
Does doxazosin compared to terazosin improve IPSS and Qmax in male patients with LUTS suggestive of BPH?
Doxazosin and terazosin are equally effective for treating LUTS in BPH, and switching between these alpha-blockers in non-responders is generally ineffective.
Answers are grounded in this paper and cite their sources.
Either doxazosin or terazosin may be used first-line for BPH-related LUTS; confirms their equivalence in a direct RCT.
OBJECTIVE: To compare the effects of the doxazosin and terazosin on total International Prostate Symptom Score (IPSS) and maximum urinary flow rate (Qmax) in treating patients with lower urinary tract symptoms (LUTS) and compare this effectivity by switching the drugs in the patients who did not benefit from either the first or the second drug. METHODS: This is a prospective randomized study of the patients with LUTS suggestive of benign prostatic hyperplasia (BPH). Fifty male patients (mean age 59.4 +/- 7.6 years) received either doxazosin (n = 25) or terazosin (n = 25) once daily every night. The patients were evaluated in the 1st, 2nd and 3rd months of treatment. Minimum 20% improvement in IPSS and Qmax in the 3rd month was considered as improvement. The patients with no improvement in any of the parameters switched the drugs, and they were followed up in the next 3 months. The patients whose only one parameter improved were excluded from the study. RESULTS: Eleven (44%) out of 25 patients using doxazosin and 10 (40%) out of 25 patients using terazosin showed improvement in both IPSS and Qmax at the end of the 3rd month and continued using the drug. After 3 months of treatment, increase in Qmax (p < 0.001) and decrease in IPSS (p < 0.01) was significant for both doxazosin and terazosin. Nineteen patients, who did not show improvement in any of the parameters, switched the drug. Of the patients who switched the drug, 2 (4%) showed improvement both in IPSS and in Qmax, while 2 (4%) showed improvement only in IPSS but not in Qmax. The remaining 15 (30%) patients did not show improvement in any of the parameters. CONCLUSION: The results of the study suggest that alpha-blockade with either doxazosin or terazosin is effective in males with LUTS. The two alpha-blocking drugs showed equal effectiveness in the treatment of LUTS. If one of the drugs is ineffective in the treatment of LUTS, then the other drug will probably be ineffective.
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Şamlı et al. (2004) conducted an RCT in Lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) (n=50). Doxazosin vs. Terazosin was evaluated on Minimum 20% improvement in both IPSS and Qmax at the end of the 3rd month. Doxazosin and terazosin showed similar effectiveness in treating LUTS, with 44% and 40% of patients respectively achieving improvement in both IPSS and Qmax at 3 months.
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