Literature DB >> 18542722

Finasteride monotherapy maintains stable lower urinary tract symptoms in men with benign prostatic hyperplasia following cessation of alpha blockers.

J Curtis Nickel1, Jack Barkin, Caroline Koch, Charles Dupont, Mostafa Elhilali.   

Abstract

OBJECTIVE: Our Canadian multicentre open-label study sought to evaluate, in patients with moderate/severe lower urinary symptoms (LUTS) secondary to benign prostatic hyperplasia, the effect on symptoms of 9 months of monotherapy with finasteride 5 mg following 9 months of combination treatment (finasteride with an alpha-blocker) as quantified according to the International Prostate Symptom Score (IPSS).
METHODS: The primary outcome measure for efficacy was the maintenance of IPSS response after cessation of the alpha-blocker. Subjects were treated with a combination of finasteride and an alpha-blocker for 9 months and then with finasteride alone for 3 or 9 months.
RESULTS: Results showed that the IPSS scores after 3 months of monotherapy were within the criteria for equivalence to those after 9 months of combination therapy. Symptom control equivalence was also found after 9 months of monotherapy. The IPSS response rate was also similar for combination and monotherapy. The safety profile was similar and as expected with these medications.
CONCLUSION: Control of LUTS associated with BPH thus appears to be maintained for at least 9 months with finasteride alone, following a 9-month course of combination therapy with finasteride and an alpha-blocker, with similar safety profiles.

Entities:  

Year:  2008        PMID: 18542722      PMCID: PMC2422879          DOI: 10.5489/cuaj.520

Source DB:  PubMed          Journal:  Can Urol Assoc J        ISSN: 1911-6470            Impact factor:   1.862


  11 in total

1.  Long-term effects of finasteride on prostate tissue composition.

Authors:  L S Marks; A W Partin; F J Dorey; G J Gormley; J I Epstein; J B Garris; M L Macairan; E D Shery; P B Santos; E Stoner; J B deKernion
Journal:  Urology       Date:  1999-03       Impact factor: 2.649

2.  Discontinuation of alpha-blockade after initial treatment with finasteride and doxazosin for bladder outlet obstruction.

Authors:  K C Baldwin; P C Ginsberg; R C Harkaway
Journal:  Urol Int       Date:  2001       Impact factor: 2.089

3.  5-alpha-Reductase Inhibitors Prevent the Progression of Benign Prostatic Hyperplasia.

Authors:  Claus G Roehrborn
Journal:  Rev Urol       Date:  2003

4.  Discontinuation of alpha-blockade after initial treatment with finasteride and doxazosin in men with lower urinary tract symptoms and clinical evidence of benign prostatic hyperplasia.

Authors:  K C Baldwin; P C Ginsberg; C G Roehrborn; R C Harkaway
Journal:  Urology       Date:  2001-08       Impact factor: 2.649

5.  Alpha-blocker therapy can be withdrawn in the majority of men following initial combination therapy with the dual 5alpha-reductase inhibitor dutasteride.

Authors:  J Barkin; M Guimarães; G Jacobi; D Pushkar; S Taylor; O B van Vierssen Trip
Journal:  Eur Urol       Date:  2003-10       Impact factor: 20.096

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

Authors:  John D McConnell; Claus G Roehrborn; Oliver M Bautista; Gerald L Andriole; Christopher M Dixon; John W Kusek; Herbert Lepor; Kevin T McVary; Leroy M Nyberg; Harry S Clarke; E David Crawford; Ananias Diokno; John P Foley; Harris E Foster; Stephen C Jacobs; Steven A Kaplan; Karl J Kreder; Michael M Lieber; M Scott Lucia; Gary J Miller; Mani Menon; Douglas F Milam; Joe W Ramsdell; Noah S Schenkman; Kevin M Slawin; Joseph A Smith
Journal:  N Engl J Med       Date:  2003-12-18       Impact factor: 91.245

7.  Efficacy and tolerability of doxazosin and finasteride, alone or in combination, in treatment of symptomatic benign prostatic hyperplasia: the Prospective European Doxazosin and Combination Therapy (PREDICT) trial.

Authors:  Roger S Kirby; Claus Roehrborn; Peter Boyle; Georg Bartsch; Alain Jardin; Margaret M Cary; Michael Sweeney; Eric B Grossman
Journal:  Urology       Date:  2003-01       Impact factor: 2.649

8.  The efficacy of terazosin, finasteride, or both in benign prostatic hyperplasia. Veterans Affairs Cooperative Studies Benign Prostatic Hyperplasia Study Group.

Authors:  H Lepor; W O Williford; M J Barry; M K Brawer; C M Dixon; G Gormley; C Haakenson; M Machi; P Narayan; R J Padley
Journal:  N Engl J Med       Date:  1996-08-22       Impact factor: 91.245

Review 9.  The long-term outcome of medical therapy for BPH.

Authors:  Stephan Madersbacher; Martin Marszalek; Jakob Lackner; Peter Berger; Georg Schatzl
Journal:  Eur Urol       Date:  2007-03-28       Impact factor: 20.096

10.  Benign prostatic hyperplasia specific health status measures in clinical research: how much change in the American Urological Association symptom index and the benign prostatic hyperplasia impact index is perceptible to patients?

Authors:  M J Barry; W O Williford; Y Chang; M Machi; K M Jones; E Walker-Corkery; H Lepor
Journal:  J Urol       Date:  1995-11       Impact factor: 7.450

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  15 in total

1.  2010 Update: Guidelines for the management of benign prostatic hyperplasia.

Authors:  J Curtis Nickel; Carlos E Méndez-Probst; Thomas F Whelan; Ryan F Paterson; Hassan Razvi
Journal:  Can Urol Assoc J       Date:  2010-10       Impact factor: 1.862

2.  Assessing the cost-benefit relationship in BPH therapy.

Authors:  Jason Izard
Journal:  Can Urol Assoc J       Date:  2013 May-Jun       Impact factor: 1.862

Review 3.  [Combined treatment of BPS with tamsulosin and finasteride : Literature review and prescription data].

Authors:  K Höfner; S Ulrich; R Berges
Journal:  Urologe A       Date:  2017-05       Impact factor: 0.639

4.  Canadian Urological Association guideline on male lower urinary tract symptoms/benign prostatic hyperplasia (MLUTS/BPH): 2018 update.

Authors:  J Curtis Nickel; Lorne Aaron; Jack Barkin; Dean Elterman; Mahmoud Nachabé; Kevin C Zorn
Journal:  Can Urol Assoc J       Date:  2018-10       Impact factor: 1.862

5.  Evidence-based guidelines for the treatment of lower urinary tract symptoms related to uncomplicated benign prostatic hyperplasia in Italy: updated summary from AURO.it.

Authors:  Sebastiano Spatafora; Antonio Casarico; Andrea Fandella; Caterina Galetti; Rodolfo Hurle; Elisa Mazzini; Ciro Niro; Massimo Perachino; Roberto Sanseverino; Giovanni Luigi Pappagallo
Journal:  Ther Adv Urol       Date:  2012-12

Review 6.  [Importance of adrenoceptor blockers and alpha reductase inhibitors : Monotherapy for treatment of benign prostate syndrome].

Authors:  F Strittmatter; S Madersbacher; C G Stief; C Gratzke
Journal:  Urologe A       Date:  2013-02       Impact factor: 0.639

7.  [Medical therapy of lower urinary tract symptoms [corrected]].

Authors:  F Strittmatter; S Madersbacher; C G Stief; C Gratzke
Journal:  Urologe A       Date:  2012-08       Impact factor: 0.639

8.  The Canadian Benign Prostatic Hyperplasia Audit Study (CanBas).

Authors:  J Curtis Nickel; Joe Downey; Francois Bénard; Michael Chetner; John Grantmyre; Alan So; Paul Whelan
Journal:  Can Urol Assoc J       Date:  2008-08       Impact factor: 1.862

9.  Diagnosis and management of benign prostatic hyperplasia in primary care.

Authors:  Simon Tanguay; Murray Awde; Gerald Brock; Richard Casey; Joseph Kozak; Jay Lee; J Curtis Nickel; Fred Saad
Journal:  Can Urol Assoc J       Date:  2009-06       Impact factor: 1.862

Review 10.  Current status of 5alpha-reductase inhibitors in the management of lower urinary tract symptoms and BPH.

Authors:  Stavros Gravas; Matthias Oelke
Journal:  World J Urol       Date:  2009-12-03       Impact factor: 4.226

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