title: The efficacy of terazosin, finasteride, or both in benign prostatic hyperplasia. Veterans Affairs Cooperative Studies Benign Prostatic Hyperplasia Study Group.
abstract: BACKGROUND
  Men with benign prostatic hyperplasia can be treated with alpha 1-adrenergic-antagonist drugs that relax prostatic smooth muscle or with drugs that inhibit 5 alpha-reductase and therefore reduce tissue androgen concentrations. However, the effects of the two types of drugs have not been compared.
  
  
  METHODS
  We compared the safety and efficacy of placebo, terazosin (10 mg daily), finasteride (5 mg daily), and the combination of both drugs in 1229 men with benign prostatic hyperplasia. American Urological Association symptom scores and peak urinary-flow rates were determined at base line and periodically for one year.
  
  
  RESULTS
  The mean changes from base line in the symptom scores in the placebo, finasteride, terazosin, and combination-therapy groups at one 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 the 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 terazosin and combination therapy with finasteride and with placebo). Finasteride had no more effect on either measure than placebo. In the placebo group, 1.6 percent of the men discontinued the study because of adverse effects, as did 4.8 to 7.8 percent of the men in the other three groups.
  
  
  CONCLUSIONS
  In men with benign prostatic hyperplasia, terazosin was effective therapy, whereas finasteride was not, and the combination of terazosin and finasteride was no more effective than terazosin alone.
authors.affiliation: Veterans Affairs Medical Center, New York, USA.
authors.forename: H
authors.initials: H
authors.lastname: Lepor
authors.forename: W O
authors.initials: WO
authors.lastname: Williford
authors.forename: M J
authors.initials: MJ
authors.lastname: Barry
authors.forename: M K
authors.initials: MK
authors.lastname: Brawer
authors.forename: C M
authors.initials: CM
authors.lastname: Dixon
authors.forename: G
authors.initials: G
authors.lastname: Gormley
authors.forename: C
authors.initials: C
authors.lastname: Haakenson
authors.forename: M
authors.initials: M
authors.lastname: Machi
authors.forename: P
authors.initials: P
authors.lastname: Narayan
authors.forename: R J
authors.initials: RJ
authors.lastname: Padley
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004791:Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D018120:Finasteride / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010088:Oxidoreductases / Q000037:antagonists & inhibitors*; D011224:Prazosin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011470:Prostatic Hyperplasia / Q000188:drug therapy*; D016896:Treatment Outcome; D014563:Urodynamics / Q000187:drug effects
chemical_list: D000317:Adrenergic alpha-Antagonists; D004791:Enzyme Inhibitors; D018120:Finasteride; C041226:Terazosin; D010088:Oxidoreductases; D011224:Prazosin