Johns Hopkins Health Alert
Medications for BPH: What Works Best?
The prescription drugs available for treating benign prostatic hyperplasia (BPH, also known as enlarged prostatic enlargement or BPE) fall into two categories: alpha-blockers and 5-alpha-reductase inhibitors. Although research suggests that 30 to 60 percent of men will be helped by these drugs, it's not possible to predict which men will benefit from them or which drug will work best for which person.
It's estimated that 1.5 million American men are currently on a lifetime regimen of prostate medications. To date, no medication offers a cure for BPH -- the drugs only diminish BPH symptoms. Once any medication is stopped, BPH symptoms will recur.
- How do you decide whether to use an alpha-blocker or a 5-alpha-reductase inhibitor for treating bothersome BPH symptoms?
When the patient is symptomatic, the best and fastest way to help him is generally with an alpha-blocker. There is no difference in response rates based on a patient's age, symptom severity, flow rate, prostate volume or PSA. The drugs all seem to work equally well.
- Is there any benefit to combination therapy -- taking an alpha-blocker and a 5-alpha-reductase inhibitor at the same time?
The data from the multicenter MTOPS (Medical Therapy Of Prostatic Symptoms) trial reported very clearly that combination therapy is the best way to treat BPH symptoms as well as to prevent the progression of the disease.
Over a five-year span, this NIH-sponsored study of 3,000 men with symptomatic BPH compared the effects of Proscar, Cardura, the combination of the two and placebo. It was the largest, longest study of its kind. Results from the 17-center study showed that combination therapy with Cardura and Proscar slowed the progression of signs and symptoms of BPH to a much greater extent than monotherapy with either drug.
Posted in Enlarged Prostate on July 10, 2012
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