EFFECTS OF DOXAZOSIN IN PATIENTS WITH MILD, INTERMEDIATE, AND SEVERE BENIGN PROSTATIC HYPERPLASIA

Traditionally, drug therapy for benign prostatic hyperplasia (BPH) has been reserved for patients with mild or moderate symptoms. The object ive of this analysis was to compare responses to an alpha(1)-adrenergi c receptor blocker, doxazosin, in patients with severe, intermediate, and mild disease. Data were analyzed from patients with symptomatic BP H who were enrolled in two 16-week, double-masked, placebo-controlled studies of doxazosin. In study 1, 163 hypertensive patients were strat ified according to baseline maximum (Q(max)) and mean (Q(mean)) urinar y flow rate as having severe, intermediate, or mild disease. In study 2, 82 normotensive patients were stratified according to their baselin e American Urological Association (AUA) BPH symptom severity score and modified Boyarsky symptom bothersome-ness score. Overall, doxazosin w as significantly more effective than placebo in improving Q(max) and Q (mean) in study 1 and in improving the AUA-derived and modified Boyars ky scores in study 2. There were statistically significant differences in the response to treatment, as represented by Q(max), Q(mean), and modified Boyarsky score, between patients with severe, intermediate, a nd mild disease. There were no significant differences in the AUA-deri ved scores of patients in the three severity groups. These results hav e important clinical implications, suggesting that the majority of BPH patients are candidates for a course of drug therapy, regardless of b ase line disease status.