THE EFFICACY OF TERAZOSIN, FINASTERIDE, OR BOTH IN BENIGN PROSTATIC HYPERPLASIA

Background Men with benign prostatic hyperplasia can be treated with a lpha(1)-adrenergic-antagonist drugs that relax prostatic smooth muscle or with drugs that inhibit 5 alpha-reductase and therefore reduce tis sue androgen concentrations. However, the effects of the two types of drugs have not been compared. Methods We compared the safety and effic acy of placebo, terazosin (10 mg daily), finasteride (5 mg daily), and the combination of both drugs in 1229 men with benign prostatic hyper plasia. American Urological Association symptom scores and peak urinar y-flow rates were determined at base line and periodically for one yea r. Results The mean changes from base line in the symptom scores in th e placebo, finasteride, terazosin, and combination-therapy groups at o ne year were decreases of 2.6, 3.2, 6.1, and 6.2 points, respectively (P<0.001 for the comparisons of both terazosin and combination therapy with finasteride and with placebo). The mean changes at one year in t he peak urinary-flow rates were increases of 1.4, 1.6, 2.7, and 3.2 ml per second, respectively (P<0.001 for the comparisons of both terazos in and combination therapy with finasteride and with placebo). Finaste ride had no more effect on either measure than placebo, In the placebo group, 1.6 percent of the men discontinued the study because of adver se effects, as did 4.8 to 7.8 percent of the men in the other three gr oups. Conclusions In men with benign prostatic hyperplasia, terazosin was effective therapy, whereas finasteride was not, and the combinatio n of terazosin and finasteride was no more effective than terazosin al one. (C) 1996, Massachusetts Medical Society.