Chung Byung Ha, Hong Sung Joon, Lee Moo Sang
Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
Int J Urol. 2005 Feb;12(2):159-65. doi: 10.1111/j.1442-2042.2005.00998.x.
Few studies have reported the treatment of benign prostatic hyperplasia (BPH) in Asian patients. We assessed the safety and efficacy of doxazosin, a selective alpha1-adrenoceptor antagonist, in the treatment of Korean patients with symptomatic BPH.
Two hundred and ninety-five men, aged 48 years or older with clinical BPH, were enrolled in a 12-week, open-label, baseline-controlled, dose-titration, multicenter study. A 2-week, single-blind, placebo run-in was followed by 10 weeks of doxazosin treatment, initially administered at 1 mg/day, with upward titrations (2, 4, or 8 mg/day) at 2-week intervals. The international prostate symptom score (IPSS) was used to assess efficacy after 4, 6, and 10 weeks of active treatment.
The intent-to-treat (ITT) population comprised 249 patients (mean age 63.6 years). Doxazosin significantly reduced the mean total IPSS by 48%; similarly, the obstructive and irritative subscores were reduced from baseline by 51% and 39%, respectively (P < 0.001 for all scores: Wilcoxon rank sum test). In a subset analysis of 170 normotensive and 78 hypertensive patients, significant reductions in mean systolic and diastolic blood pressures relative to baseline were observed only in the hypertensive subset (P < 0.01). Similar results in mean IPSS were observed in older (> or =65 years, n = 100) and younger (45-64 years, n = 140) patients, as well as between normotensive and hypertensive patients. Thirty-nine patients reported adverse events: The most frequent were dizziness, dyspepsia, asthenia, somnolence, and dry mouth.
The efficacy and safety of doxazosin treatment for BPH were confirmed in this Asian population. Significant improvements in total IPSS, as well as obstructive and irritative subscores, were observed.
很少有研究报道亚洲患者良性前列腺增生(BPH)的治疗情况。我们评估了选择性α1肾上腺素能受体拮抗剂多沙唑嗪治疗有症状的韩国BPH患者的安全性和有效性。
295名年龄在48岁及以上的临床BPH男性患者参加了一项为期12周的开放标签、基线对照、剂量滴定、多中心研究。先进行为期2周的单盲安慰剂导入期,随后进行10周的多沙唑嗪治疗,初始剂量为1毫克/天,每2周递增(2、4或8毫克/天)。在积极治疗4、6和10周后,使用国际前列腺症状评分(IPSS)评估疗效。
意向性治疗(ITT)人群包括249名患者(平均年龄63.6岁)。多沙唑嗪使平均总IPSS显著降低了48%;同样,梗阻性和刺激性子评分分别较基线降低了51%和39%(所有评分P<0.001:Wilcoxon秩和检验)。在对170名血压正常和78名高血压患者的亚组分析中,仅在高血压亚组中观察到平均收缩压和舒张压相对于基线有显著降低(P<0.01)。在年龄较大(≥65岁,n = 100)和较年轻(45 - 64岁,n = 140)的患者中,以及血压正常和高血压患者之间,观察到平均IPSS有类似结果。39名患者报告了不良事件:最常见的是头晕、消化不良、乏力、嗜睡和口干。
在这一亚洲人群中证实了多沙唑嗪治疗BPH的有效性和安全性。观察到总IPSS以及梗阻性和刺激性子评分有显著改善。