A Randomized, Open-Label, Comparative Study of Efficacy and Safety of Tolterodine Combined with Tamsulosin or Doxazosin in Patients with Benign Prostatic Hyperplasia.
BACKGROUND Benign prostatic hyperplasia (BPH), a common disease in men over age 50 years, often causes bladder outlet obstruction and lower urinary tract symptoms (LUTS). Alpha blockers in combination with muscarinic receptor antagonists may have the potential to improve symptoms. This study aimed to assess the efficacy and safety of doxazosin or tamsulosin combined with tolterodine extend release (ER) in patients with BPH and LUTS. MATERIAL AND METHODS In a prospective, randomized, open-label study (ChiCTR-IPR-15005763), 220 consecutive men with BPH and LUTS were allocated to receive doxazosin 4 mg and tolterodine ER 4 mg per day (doxazosin group) or tamsulosin 0.2 mg and tolterodine ER 4 mg per day (tamsulosin group). Treatment lasted 12 weeks. The primary endpoint was the international prostatic symptom score (IPSS). Secondary endpoints were quality of life (QoL) and maximum flow rate (Qmax), which were evaluated at 0, 6, and 12 weeks, and urodynamic parameters assessed at 0 and 12 weeks. RESULTS A total of 192 patients completed the trial. Baseline measurements showed no differences between the groups. After 6 weeks, IPSS improved in both groups and QoL was significantly better in the doxazosin group (P=0.01). After 12 weeks, Qmax, IPSS, QoL, intravesical pressure (Pves), and bladder compliance (BC) in the doxazosin group were significantly better than in the tamsulosin group (P=0.03, P<0.001, P<0.001, P=0.027, and P=0.044, respectively). CONCLUSIONS Administration of alpha blockers combined with muscarinic receptor blocker for 12 weeks improved LUTS in men with BPH.
Department of Urology, Qingdao University Affiliated Hospital, Qingdao, Shandong, China (mainland).
Yanwei
Y
Cao
Department of Urology, Qingdao University Affiliated Hospital, Qingdao, Shandong, China (mainland).
Yonghua
Y
Wang
Department of Urology, Qingdao University Affiliated Hospital, Qingdao, Shandong, China (mainland).
Lei
L
Guo
Department of Urology, Qingdao University Affiliated Hospital, Qingdao, Shandong, China (mainland).
Xuecheng
X
Yang
Department of Urology, Qingdao University Affiliated Hospital, Qingdao, Shandong, China (mainland).
Tao
T
Chen
Department of Urology, Qingdao University Affiliated Hospital, Qingdao, Shandong, China (mainland).
Haitao
H
Niu
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000368:Aged; D017292:Doxazosin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000188:drug therapy*; D011788:Quality of Life; D013449:Sulfonamides / Q000627:therapeutic use*; D000077409:Tamsulosin; D000068737:Tolterodine Tartrate / Q000627:therapeutic use*
D000317:Adrenergic alpha-Antagonists; D013449:Sulfonamides; D000068737:Tolterodine Tartrate; D000077409:Tamsulosin; D017292:Doxazosin