Alfuzosin and symptoms of chronic prostatitis-chronic pelvic pain syndrome.
BACKGROUND
In men with chronic prostatitis-chronic pelvic pain syndrome, treatment with alpha-adrenergic receptor blockers early in the course of the disorder has been reported to be effective in some, but not all, relatively small randomized trials.


METHODS
We conducted a multicenter, randomized, double-blind, placebo-controlled trial to evaluate the efficacy of alfuzosin, an alpha-adrenergic receptor blocker, in reducing symptoms in men with chronic prostatitis-chronic pelvic pain syndrome. Participation in the study required diagnosis of the condition within the preceding 2 years and no previous treatment with an alpha-adrenergic receptor blocker. Men were randomly assigned to treatment for 12 weeks with either 10 mg of alfuzosin per day or placebo. The primary outcome was a reduction of at least 4 points (from baseline to 12 weeks) in the score on the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) (range, 0 to 43; higher scores indicate more severe symptoms). A 4-point decrease is the minimal clinically significant difference in the score.


RESULTS
A total of 272 eligible participants underwent randomization, and in both study groups, 49.3% of participants had a decrease of at least 4 points in their total NIH-CPSI score (rate difference associated with alfuzosin, 0.1%; 95% confidence interval, -11.2 to 11.0; P=0.99). In addition, a global response assessment showed similar response rates at 12 weeks: 33.6% in the placebo group and 34.8% in the alfuzosin group (P=0.90). The rates of adverse events in the two groups were also similar.


CONCLUSIONS
Our findings do not support the use of alfuzosin to reduce the symptoms of chronic prostatitis-chronic pelvic pain syndrome in men who have not received prior treatment with an alpha-blocker. (ClinicalTrials.gov number, NCT00103402.)
Nickel
J Curtis
JC
Department of Urology, Queen's University, Kingston, ON, Canada. jcn@queensu.ca
Krieger
John N
JN
McNaughton-Collins
Mary
M
Anderson
Rodney U
RU
Pontari
Michel
M
Shoskes
Daniel A
DA
Litwin
Mark S
MS
Alexander
Richard B
RB
White
Paige C
PC
Berger
Richard
R
Nadler
Robert
R
O'Leary
Michael
M
Liong
Men Long
ML
Zeitlin
Scott
S
Chuai
Shannon
S
Landis
J Richard
JR
Kusek
John W
JW
Nyberg
Leroy M
LM
Schaeffer
Anthony J
AJ
D000317:Adrenergic alpha-Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D017699:Pelvic Pain / Q000188:drug therapy*; D011472:Prostatitis / Q000188:drug therapy*; D011799:Quinazolines / Q000009:adverse effects / Q000627:therapeutic use*; D012720:Severity of Illness Index; D017211:Treatment Failure; D055815:Young Adult
D000317:Adrenergic alpha-Antagonists; D011799:Quinazolines; C047638:alfuzosin