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Clinical significance of α1-adrenoceptor selectivity in the management of benign prostatic hyperplasia

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Abstract

Alpha1-adrenoceptor antagonists have beenshown to provide effective relief from symptomsof benign prostatic hyperplasia (BPH) withattendant improvements in quality of life.Although the α1A-adrenoceptorsubtype predominates over other subtypes ofα1 adrenoceptors in the prostategland, there is no evidence that a subselectiveα-adrenoceptor antagonist provides aclinical advantage over a selectiveα1-adrenoceptor antagonist in thetreatment of patients with BPH. Thepharmacokinetic profiles ofα1A-adrenoceptorantagonists and their documented penetration ofthe blood-brain barrier (CNS adverse effects)preclude a clinical benefit of subselectiveα-adrenoceptor blockers over selectiveα1 blockers.

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References

  1. Oesterling JE. Benign prostatic hyperplasia. Its natural history, epidemiologic characteristics, and surgical treatment. Arch Fam Med 1992; 1: 257

    Google Scholar 

  2. Tammela T. Benign prostatic hyperplasia. Drugs Aging 1997; 10: 349

    Google Scholar 

  3. Bylund B, Eikenberg D, Hiebel J. et al. International union of pharmacology nomenclature of adrenoceptors. Pharmacol Rev 1994; 46: 121

    Google Scholar 

  4. Hieble JP, Bylund DB, Clarke DE et al. International Union of Pharmacology. X. Recommendation for nomenclature of alpha 1-adrenoceptors: Consensus update. Pharmacol Rev 1995; 47: 267

    Google Scholar 

  5. Barry MJ, Cockett AT, Holtgrewe HL et al. Relationship of symptoms of prostatism to commonly used physiological and anatomical measures of the severity of benign prostatic hyperplasia. J Urol 1993; 150: 351

    Google Scholar 

  6. Berry S, Coffey D, Wash P, Ewing L. The development of benign prostatic hyperplasia. J Urol 1984; 132: 474

    Google Scholar 

  7. Abrams P. New words for old: lower urinary tract symptoms for “prostatism” [editorial]. Br Med J 1994; 308: 929

    Google Scholar 

  8. Caine M. The present role of alpha-adrenergic blockers in the treatment of benign prostatic hypertrophy. J Urol 1986; 136:1

    Google Scholar 

  9. Furuya S, Kumamoto Y, Yokoyama E et al. Alpha-adrenergic activity and urethral pressure in prostatic zone in benign prostatic hypertrophy. J Urol 1982; 128: 836

    Google Scholar 

  10. Caine M, Raz S. Some clinical implications of adrenergic receptors in the urinary tract. Arch Surg 1975; 110: 247

    Google Scholar 

  11. Lepor H, Tang R, Shapiro E. he alpha-adrenoceptor subtype mediating the tension of human prostatic smooth muscle. Prostate 1993; 22: 301

    Google Scholar 

  12. Lepor H. Rationale for alpha-blockade in BPH therapy. In Cockett A, Khoury S, Aso Y, et al., eds. The 3rd Interna-tional Consultation on Benign Prostatic Hyperplasia (BPH). Monaco: Scientific Communication International Ltd, June 26–28, 1998

    Google Scholar 

  13. Andersson KE. Prostatic and extraprostatic alpha-adreno-ceptors – contributions to the lower urinary tract symptoms in benign prostatic hyperplasia. Scand J Urol Nephrol Suppl 1996; 179: 105

    Google Scholar 

  14. Kirby R, Pool J. Alpha adrenoceptor blockade in the treatment of benign prostatic hyperplasia: past, present and future. Br J Urol 1997; 80: 521

    Google Scholar 

  15. Andersson K Lepor H, Wyllie M. Prostatic alpha 1-adreno-ceptors and uroselectivity. Prostate 1997; 30: 202

    Google Scholar 

  16. Andersson K. Uroselectivity. In Cockett A, Khoury S, Aso Y et al.,eds. Proceedings of the 3rd International Consultation on Benign Prostatic Hyperplasia (BPH). Monaco: Scientific Communication International Ltd, June 26–28, 1995

    Google Scholar 

  17. Forray C, Bard J, Wetzel J,et al. The alpha 1-adrenergic receptor that mediates smooth muscle contraction in human prostate has the pharmacological properties of the cloned human alpha 1c subtype. Mol Pharmacol 1994; 45: 703

    Google Scholar 

  18. Andersson KE. The concept of uroselectivity. Eur Urol 1998; 33: 7

    Google Scholar 

  19. Boyle P, Napalkov P. The epidemiology of benign prostatic hyperplasia and observations on concomitant hypertension. Scand J Urol Nephrol Suppl 1995; 168: 7

    Google Scholar 

  20. Chapple C, Andersson K, Bono V et al. Alpha-blockers clin-ical results. In Denis L, McConnell J, Yoshida O et al., eds.4th International Consultation on BPH: Recommendations of the International Scientific Committee: The Evaluation and Treatment of Lower Urinary Tract Symptoms (LUTS) Suggestive of Benign Prostatic Obstruction. Paris: Scientific Communication International Ltd, July 2–5, 1998

    Google Scholar 

  21. Caine M, Perlberg S, Meretyk S. A placebo-controlled double-blind study of the effect of phenoxybenzamine in benign prostatic obstruction. Br J Urol 1978; 50: 551

    Google Scholar 

  22. Caine M, Perlberg S, Shapiro A.Phenoxybenzamine for benign prostatic obstruction. Review of 200 cases. Urology 1981; 17: 542

    Google Scholar 

  23. Kirby RS, Coppinger SW, Corcoran MO, Chapple CR et al. Prazosin in the treatment of prostatic obstruction. A placebo-controlled study. Br J Urol 1987; 60: 136

    Google Scholar 

  24. Hedlund H, Andersson KE, Larsson B. Alpha-adrenoceptors and muscarinic receptors in the isolated human prostate. J Urol 1985; 134: 1291

    Google Scholar 

  25. Chapple C, Carter P, Christmas T et al. A three-month double-blind study of doxazosin as treatment for benign prostatic bladder outlet obstruction. Br J Urol 1994; 74: 50

    Google Scholar 

  26. Kirby R, Chapple C, Sethia K et al. Morning vs. evening dosing with doxazosin in benign prostatic hyperplasia: efficacy and safety. Prostate Cancer Prostatic Dis 1998; 1: 163

    Google Scholar 

  27. Kaplan S, Soldo K, Olsson C. Terazosin and doxazosin in normotensive men with symptomatic prostatism: a pilot study to determine the effect of dosing regimen on efficacy and safety. Eur Urol 1995; 28: 223

    Google Scholar 

  28. Bendix Holme J, Christensen MM, Rasmussen PC et al. 29-week doxazosin treatment in patients with sympto-matic benign prostatic hyperplasia. A double-blind placebo-controlled study. Scand J Urol Nephrol 1994; 28: 77

    Google Scholar 

  29. Christensen M, Bendix Holme J, Rasmussen P, et al. Doxazosin treatment in patients with prostatic obstruction. Scand J Urol Nephrol 1993; 27: 39

    Google Scholar 

  30. Fawzy A, Hendry A, Cook E, Gonzalez F. Long-term (4 year) efficacy and tolerability of doxazosin for the treatment of concurrent benign prostatic hyperplasia and hypertension. Int J Urol 1999a; 6: 346

    Google Scholar 

  31. Fawzy A, Braun K, Lewis G et al. Doxazosin in the treatment of benign prostatic hyperplasia in normotensive patients: a multicenter study. J Urol 1995; 154: 105

    Google Scholar 

  32. Janknegt R, Chapple C. Efficacy and safety of the alpha-1 blocker doxazosin in the treatment of benign prostatic hyperplasia. Analysis of 5 studies. Eur Urol 1993; 24: 319

    Google Scholar 

  33. Fulton B, Wagstaff A, Sorkin E. Doxazosin: an update of its clinical pharmacology and therapeutic applications in the treatment of hypertension and BPH. Drugs 1995; 49: 295

    Google Scholar 

  34. Joint National Committee: The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Arch Intern Med 1997; 157: 2413

    Google Scholar 

  35. Lepor H, Kaplan S, Klimberg I et al. Doxazosin for benign prostatic hyperplasia: long-term efficacy and safety in hyper-tensive and normotensive patients. J Urol 1997; 157: 525

    Google Scholar 

  36. Fawzy A, Vashi V, Chung M et al. Clinical correlation of maximal urinary flow rate and plasma doxazosin concen-trations in the treatment of benign prostatic hyperplasia. Multicenter Study Group. Urology 1999b; 53: 329

    Google Scholar 

  37. Kirby R. Doxazosin in benign prostatic hyperplasia: effects on blood pressure and urinary flow in normotensive and hypertensive men. Urology 1995; 46: 182

    Google Scholar 

  38. Gillenwater J, Conn R, Chrysant S, et al. Doxazosin for the treatment of benign prostatic hyperplasia in patients with mild to moderate essential hypertension: a double-blind, placebo-controlled, dose-response multicenter study. J Urol 1995; 154: 110

    Google Scholar 

  39. Kaplan S, Meade-D'Alisera P, Quinones S, Soldo KA. Doxazosin in physiologically and pharmacologically normotensive men with benign prostatic hyperplasia. Urology 1995; 46: 512

    Google Scholar 

  40. Black H, Sollins J, Garafalo J. The addition of doxazosin to the therapeutic regimen of hypertensive patients inadequately controlled on other antihypertensive medications: a random-ised, placebo-controlled study. Am J Hypertens. In press

  41. Grimm R Jr, Flack J, Grandits G, et al. Long-term effects on plasma lipids of diet and drugs to treat hypertension. JAMA 1996; 275: 1549

    Google Scholar 

  42. Stott MA, Abrams P. Indoramin in the treatment of prostatic bladder outflow obstruction. Br J Urol 1991; 67: 499

    Google Scholar 

  43. Lepor H.Long-term evaluation of tamsulosin in benign prostatic hyperplasia: placebo-controlled, double-blind exten-sion of phase III trial. Tamsulosin Investigator Group. Urology 1998a; 51: 901

    Google Scholar 

  44. Lepor H. Phase III multicenter placebo-controlled study of tamsulosin in benign prostatic hyperplasia. Tamsulosin Invest-igator Group. Urology 1998b; 51: 892

    Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA

    James L. Pool

  2. St. George's Hospital, 145 Harley Street, London, WIG 6DE, UK

    Roger S. Kirby (Consultant Urologist)

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  1. James L. Pool
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  2. Roger S. Kirby
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Pool, J.L., Kirby, R.S. Clinical significance of α1-adrenoceptor selectivity in the management of benign prostatic hyperplasia. Int Urol Nephrol 33, 407–412 (2001). https://doi.org/10.1023/A:1019504703485

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