title: The effect of doxazosin, finasteride and combination therapy on nocturia in men with benign prostatic hyperplasia.
abstract: OBJECTIVE
  We evaluated the effectiveness of single or combination drug therapy on nocturia in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia.
  
  
  METHODS
  A total of 3,047 men with lower urinary tract symptoms/benign prostatic hyperplasia enrolled in the Medical Therapy of Prostatic Symptoms trial were randomly assigned to receive doxazosin alone, finasteride alone, combination therapy or placebo. Treatment effectiveness was assessed according to intent to treat by mean reduction in self-reported nightly nocturia at 1 and 4 years. A subgroup analysis by age (younger than 70 vs 70 years old or older) was also performed.
  
  
  RESULTS
  Of the men 2,583 reported 1 or more episodes of nocturia and finished 12 or more months of the trial. Mean nocturia was similar in all groups at baseline. Mean nocturia was reduced at 1 year by 0.35, 0.40, 0.54 and 0.58 in the placebo, finasteride, doxazosin and combination groups, respectively. Reductions with doxazosin and combination therapy were statistically greater than with placebo (p <0.05). At 4 years nocturia was also significantly reduced in patients treated with doxazosin and combination therapy (p <0.05 vs placebo). In men older than 70 years (495) all drugs significantly reduced nocturia at 1 year (finasteride 0.29, doxazosin 0.46 and combination 0.42) compared to placebo (0.11, p <0.05).
  
  
  CONCLUSIONS
  Doxazosin and combination therapy reduced nocturia more than placebo, but the net benefit of active drug compared to placebo was often modest with a net difference of less than 0.20 fewer nightly nocturia episodes at 1 and 4 years. Findings in men 70 years old or older were similar, with an even smaller effect observed for finasteride.
authors.affiliation: Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Atlanta Veterans Affairs Medical Center, Decatur, Georgia 30033, USA.
authors.forename: Theodore M
authors.initials: TM
authors.lastname: Johnson
authors.forename: Pamela K
authors.initials: PK
authors.lastname: Burrows
authors.forename: John W
authors.initials: JW
authors.lastname: Kusek
authors.forename: Leroy M
authors.initials: LM
authors.lastname: Nyberg
authors.forename: J Lisa
authors.initials: JL
authors.lastname: Tenover
authors.forename: Herbert
authors.initials: H
authors.lastname: Lepor
authors.forename: Claus G
authors.initials: CG
authors.lastname: Roehrborn
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D017292:Doxazosin / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D018120:Finasteride / Q000008:administration & dosage / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D053158:Nocturia / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D010865:Pilot Projects; D011470:Prostatic Hyperplasia / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D016896:Treatment Outcome; D014563:Urodynamics / Q000187:drug effects
chemical_list: D000317:Adrenergic alpha-Antagonists; D004791:Enzyme Inhibitors; D018120:Finasteride; D017292:Doxazosin