Source: DGNews  |  Posted 4 years ago

By Laura Gater

ANAHEIM, CA -- May 25, 2007 -- Finasteride, doxazosin, and a combination of the 2 drugs all demonstrate a modest but statistically significant long-term reduction in nocturia in elderly men, according to results from the Medical Therapy of Prostatic Symptoms (MTOPS) study presented here at the American Urological Association (AUA) annual meeting on May 22[^]nd[].

Doxazosin offered statistically reduced nocturia episodes as captured by the International Prostate Symptom Score (IPSS) in men believed to have prostatic hyperplasia (BPH). The nocturia reductions were often modest, considering the strong effects of placebo.

Finasteride was found to possibly have benefits for outcomes in BPH, but did not, on average, reduce nocturia, noted lead author Theodore M. Johnson II, MD, MPH, associate professor, department of medicine, division of geriatric medicine & gerontology, Birmingham/Atlanta VA Medical Center, Decatur, Georgia, United States.
Combination therapy, however, did reduce the mean number of nocturia episodes.

The MTOPS trial consisted of 3,047 men over age 50 with lower urinary-tract symptoms that were suggestive of BPH, who were randomly assigned to receive 4 or 8 mg/day of doxazosin; 5 mg/day of finasteride; combination therapy; or placebo over 5 years. Of the 3,047 men at baseline, 98% had nocturia and 87% of these were followed for at least 1 year in the study.

Four-year and overall data showed statistically greater reductions in nocturia for the doxazosin and combination-treated participants ([]P[] <.05 []versus[] placebo). Compared to younger participants (under 70 years of age), the older ones had a worse response to placebo, but similar responses to all other treatments.

Although the net advantage of nocturia reduction from doxazosin therapy over placebo was statistically significant, the effect size was modest, with a reduction of less than 0.20 fewer nocturia episodes at both 1 and 4 years.

The secondary analysis consisted of a self-reported response regarding nocturia.

Dr. Johnson noted that the study had some limitations: secondary analysis of data where nocturia was not a principal outcome; nocturia is an estimated, self-reported average; and lack of nocturia-specific quality of life measures. The study's strengths, however, are its large sample size; use of a standard, validated instrument to assess nocturia; long-term follow up; and use of a placebo group.

[[]Presentation title: The Effect of Doxazosin, Finasteride and Combination Therapy on Nocturia in Men with Benign Prostatic Hyperplasia. Abstract 1549[]]