Combination therapy significantly delays progression of benign prostatic hyperplasia

A five-year, multicenter study, published today in The New England Journal of Medicine, provides the first scientific evidence that combining alpha-blocking doxazosin with the drug finasteride is significantly more effective than using either treatment alone, said Dr. John McConnell, UT Southwestern's executive vice president for health system affairs and lead author of the study. The clinical trial involved more than 3,000 men and 20 major medical centers across the United States and is the largest study of its kind ever conducted.

Use of finasteride alone or the combination therapy significantly reduced the risk of acute urinary retention and the need for surgical intervention. A surprising finding of the study was that the alpha blocker doxazosin was not effective in reducing the long term risk of acute urinary retention or need for surgical therapy.

"Although we had predicted that combination therapy would be more effective than either drug alone, the magnitude of risk reduction was surprising," said Dr. McConnell, the former UT Southwestern chairman of urology who is internationally known for leading the development of clinical practice guidelines for the treatment of BPH in 1994. Dr. McConnell also directs the National Institutes of Health's George M. O'Brien Urologic Research Center at UT Southwestern.

These findings culminate three decades of research at UT Southwestern that began with Dr. Jean Wilson's discovery of the role of the enzyme 5-alpha reductase in benign growth of the prostate. The enzyme would later be the target for the drugs finasteride and dutasteride. The class of drugs inhibit the 5-alpha reductase enzyme, significantly lowering the level of the primary male hormone in the prostate, dihydrotestosterone, without affecting the level of testosterone elsewhere in the body.

"Dr. Wilson's discovery set in motion a whole new era of treatment," Dr. McConnell said. "What we have shown in this trial is that

Contact: Rachel Horton
UT Southwestern Medical Center

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