Comparison of 7 α1-adrenoceptor antagonists in patients with lower urinary tract symptoms associated with benign prostatic hyperplasia: A short-term crossover study

Tohru Araki, Koichi Monden, Motoo Araki

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

A crossover study was conducted to identify the best α1-adrenoceptor (α1AR) antagonist for individual patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). One hundred thirteen patients (mean age 70.8 years) were enrolled. All patients met BPH clinical study guidelines. Seven agents were utilized:tamsulosin 0.2mg, silodosin 8mg, urapidil 60mg, naftopidil 50mg, prazosin 1mg, terazosin 2mg, and doxazosin 1mg. Patients were initially prescribed tamsulosin or silodosin for a week and then urapidil for a week. Two weeks later, they were prescribed the better of the 2 agents for a week and a new agent for the next week. This cycle was repeated until all 7 agents were tested. Efficacy was evaluated with the International Prostate Symptom Score. The agent rankings were doxazosin (25 [22%]), silodosin (22 [19%]), urapidil (19 [17%]), naftopidil (17 [15%]), terazosin (12 [11%]), tamsulosin (11 [10%]), prazosin (7 [6%]). Only 12 patients (11%) changed agents after the crossover study was completed. The major reason was adverse events (83%). We found that each of the 7 α1AR antagonists has its own supporters. Further, the one-week crossover study was useful in identifying the best agent for the treatment of each individual with LUTS.

Original languageEnglish
Pages (from-to)245-251
Number of pages7
JournalActa Medica Okayama
Volume67
Issue number4
Publication statusPublished - 2013

Fingerprint

tamsulosin
Lower Urinary Tract Symptoms
Prostatic Hyperplasia
Terazosin
Cross-Over Studies
Adrenergic Receptors
Doxazosin
Prazosin
Prostate
Guidelines
urapidil
silodosin

Keywords

  • alpha-1 blockers
  • alpha1-adrenoceptor antagonists
  • Benign prostatic hyperplasia
  • Crossover study
  • Lower urinary tract symptoms

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

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title = "Comparison of 7 α1-adrenoceptor antagonists in patients with lower urinary tract symptoms associated with benign prostatic hyperplasia: A short-term crossover study",
abstract = "A crossover study was conducted to identify the best α1-adrenoceptor (α1AR) antagonist for individual patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). One hundred thirteen patients (mean age 70.8 years) were enrolled. All patients met BPH clinical study guidelines. Seven agents were utilized:tamsulosin 0.2mg, silodosin 8mg, urapidil 60mg, naftopidil 50mg, prazosin 1mg, terazosin 2mg, and doxazosin 1mg. Patients were initially prescribed tamsulosin or silodosin for a week and then urapidil for a week. Two weeks later, they were prescribed the better of the 2 agents for a week and a new agent for the next week. This cycle was repeated until all 7 agents were tested. Efficacy was evaluated with the International Prostate Symptom Score. The agent rankings were doxazosin (25 [22{\%}]), silodosin (22 [19{\%}]), urapidil (19 [17{\%}]), naftopidil (17 [15{\%}]), terazosin (12 [11{\%}]), tamsulosin (11 [10{\%}]), prazosin (7 [6{\%}]). Only 12 patients (11{\%}) changed agents after the crossover study was completed. The major reason was adverse events (83{\%}). We found that each of the 7 α1AR antagonists has its own supporters. Further, the one-week crossover study was useful in identifying the best agent for the treatment of each individual with LUTS.",
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