title: A retrospective study of clinical outcomes of α-blocker or finasteride monotherapy followed by combination therapy: determination of the period of combination therapy of α-blocker and finasteride.
abstract: OBJECTIVE
  We investigated outcomes after discontinuing alpha-blockers or finasteride in patients who initially received combination therapy and compared differences by duration of combination therapy.
  
  
  METHODS
  Patients with international prostate symptom score ≥ 8, serum prostatic-specific antigen (PSA) < 4 ng/ml, prostate volume > 25 cm(3) and combination therapy of alpha-blockers and finasteride for more than 6 months were classified into three groups. Group 1 continued combination therapy; group 2, alpha-blockers monotherapy; and group 3, finasteride monotherapy. All parameters were evaluated before and after changing to monotherapy. Patients who received combination therapy for 6-9 months and those who received combination therapy for longer were comparatively analysed.
  
  
  RESULTS
  Mean age of the 106 patients was 66.9 ± 7.8 years. No significant differences in baseline symptom scores, PSA or prostate volume were found. Following combination therapy, symptom scores, and quality of life (QoL) decreased for all groups. Group 1 maintained decreased PSA and prostate volume, and improved uroflowmetric profiles. No differences in uroflowmetric parameters were found after 6 months. Group 2 maintained improved symptoms, QoL and uroflowmetric profiles, although PSA and prostate volume returned to baseline. Group 3 maintained lowered PSA and prostate volume, whereas Qmax returned to baseline. QoL scores showed no change. Patients who received combination therapy for ≥9 months improved more in symptoms and QoL than those who received shorter combination therapy.
  
  
  CONCLUSIONS
  Discontinuation of alpha-blockers or finasteride after combination therapy for ≥ 6 months maintained improvements in symptoms. The appropriate period of combination therapy was ≥ 9 months.
authors.affiliation: Department of Urology, Seoul National University, Boramae Medical Center, Seoul, Korea.
authors.forename: H
authors.initials: H
authors.lastname: Son
authors.forename: S Y
authors.initials: SY
authors.lastname: Cho
authors.forename: S
authors.initials: S
authors.lastname: Park
authors.forename: J Y
authors.initials: JY
authors.lastname: Kang
authors.forename: C S
authors.initials: CS
authors.lastname: Kim
authors.forename: H G
authors.initials: HG
authors.lastname: Kim
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination / Q000379:methods; D018120:Finasteride / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011470:Prostatic Hyperplasia / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome; D064804:Urological Agents / Q000008:administration & dosage*
chemical_list: D000317:Adrenergic alpha-Antagonists; D064804:Urological Agents; D018120:Finasteride; D017430:Prostate-Specific Antigen