Our library of drug research abstracts drawn from the medical literature is updated on a regular schedule, and you can be assured that new doxazosin research articles will be listed here shortly after becoming available to us.
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Medical research on doxazosin
The role of combination medical therapy in benign prostatic hyperplasia.
Int J Impot Res. 2008 Dec; 20 Suppl 3: S33-43
Greco KA, McVary KT
To review key trials of monotherapy and combination therapy of alpha(1)-adrenergic receptor antagonists (alpha(1)-ARAs), 5alpha-reductase inhibitors (5alphaRIs) and anti-muscarinic agents in the treatment of lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). To assess the safety and efficacy of combination therapies for LUTS associated with BPH, a search of the MEDLINE and Cochrane databases (1976-2008) was conducted for relevant trials and reviews using the terms benign prostatic hyperplasia, lower urinary tract symptoms, alpha(1)-adrenergic receptor antagonists, 5alpha-reductase inhibitors, anti-muscarinics, anticholinergics, combination therapy, alfuzosin, doxazosin, tamsulosin, terazosin, dutasteride, finasteride, tolterodine, flavoxate, propiverine, oxybutynin, erectile dysfunction, sildenafil, vardenafil and tadalafil. Data from the Medical Therapy of Prostatic Symptoms (MTOPS) study indicated a role for long-term use of alpha(1)-ARAs and 5alphaRIs in combination. In the MTOPS study, combination therapy with the alpha(1)-ARA doxazosin and the 5alphaRI finasteride was significantly more effective than either component alone in reducing symptoms (P=0.006 vs doxazosin monotherapy; P
Circulation. 2008 Nov 25; 118(22): 2259-67
Davis BR, Kostis JB, Simpson LM, Black HR, Cushman WC, Einhorn PT, Farber MA, Ford CE, Levy D, Massie BM, Nawaz S,
BACKGROUND: Heart failure (HF) developing in hypertensive patients may occur with preserved or reduced left ventricular ejection fraction (PEF [>or=50%] or REF [
Int J Impot Res. 2008 Nov 6;
Lee HW, Jeong JY, Yang JB, Han DH, Lee SW
In this study, we evaluated the efficacy of a novel method of seminal vesicle (SV) preparation-ring preparation method-in isolated SV experiments in the rat. Rat SVs were prepared as strips and rings and applied to organ baths. The relaxation responses by sodium nitroprusside or doxazosin and contractile responses by electrical field stimulation (EFS) were recorded in both groups. We compared the proportion of tissues that showed consistent responses to the stimuli-drug or EFS-in both groups. And magnitudes of the contractile or relaxation responses were also evaluated in the two groups. In strip preparations (n=20), six tissues (30%) showed stable responses to drugs and were regarded to be useful. However, in ring preparations (n=20), 13 tissues (65%) showed stable responses (P
Int J Clin Pract. 2008 Oct; 62(10): 1547-59
Nickel JC, Sander S, Moon TD
OBJECTIVES: To evaluate the safety profile and efficacy of alpha1-adrenergic receptor blockers (A1Bs) currently prescribed for benign prostatic hyperplasia (BPH). DATA SOURCES: A systematic literature search of MEDLINE, the Cochrane Database and the Food and Drug Administration Web site through December 2006 identified double-blinded, prospective, placebo-controlled trials, evaluating agents commercially available by prescription for the symptomatic treatment of BPH. REVIEW METHODS: Data were reviewed by two investigators with the use of a standardised data abstraction form. Studies were evaluated for methodological quality using the Jadad scale. Studies with a score of < 3 were considered of weaker methodology. RESULTS: Of 2389 potential citations, 25 were usable for evaluation of safety data, 26 for efficacy. A1B use was associated with a statistically significant increase in the odds of developing a vascular-related event [odds ratio (OR) 2.54; 95% confidence interval (CI): 2.00-3.24; p < 0.0001]. The odds of developing a vascular-related adverse event were: alfuzosin, OR 1.66, 95% CI: 1.17-2.36; terazosin, OR 3.71, 95% CI: 2.48-5.53; doxazosin, OR 3.32, 95% CI: 2.10-5.23 and tamsulosin, OR 1.42, 95% CI: 0.99-2.05. A1Bs increased Q(max) by 1.32 ml/min (95% CI: 1.07-1.57) compared with placebo. Difference from placebo in American Urological Association symptom index/International Prostate Symptom Score was -1.92 points (95% CI: -2.71 to -1.14). CONCLUSIONS: Alfuzosin, terazosin and doxazosin showed a statistically significant increased risk of developing vascular-related events compared with placebo. Tamsulosin showed a numerical increase that was not statistically significant. All agents significantly improved Q(max) and symptom signs compared with placebo.
J Hypertens. 2008 Oct; 26(10): 1928-34
Matsui Y, Eguchi K, Shibasaki S, Ishikawa J, Hoshide S, Pickering TG, Shimada K, Kario K,
OBJECTIVE: Lowering of the central pulse pressure (PP) has been shown to contribute to an improvement of the cardiac damage beyond that of lowering the brachial PP. We assessed the hypothesis that the change in the central PP is more useful than that in the brachial PP in the assessment of the change in cardiac load. METHODS: We studied 434 treated hypertensive patients whose home systolic blood pressure was 135 mmHg or higher. They were followed for 6 months after allocation to either a control group or an added treatment group (doxazosin 1-4 mg and atenolol when needed). We measured the brachial and central (carotid) blood pressure simultaneously using a validated device, and the B-type natriuretic peptide at baseline and at the sixth month of treatment. RESULTS: In the added treatment group, the brachial systolic blood pressure was successfully reduced, but the central PP increased significantly, whereas the other blood pressure parameters did not change from the baseline. In the added treatment group, the change in the B-type natriuretic peptide was significantly correlated with the change in the brachial PP (r = 0.18), central systolic blood pressure (r = 0.18), central PP (r = 0.26), and PP amplification (r = -0.22) even after adjusting for the confounding factors. The correlation with the central PP was stronger than with the brachial PP (P = 0.018) or central systolic blood pressure (P = 0.002), and these relationships were essentially the same even after adjustment for the use of atenolol or the change in heart rate. CONCLUSION: This study showed that the central PP measurement may be more important to assess cardiac load than the brachial PP during antiadrenergic treatment.
[Alpha blockers in use for symptomatic benign prostatic hyperplasia--are all drugs born equal?]
Harefuah. 2008 Jun; 147(6): 514-9, 574
Bar-Yosef Y, Mabjeesh NJ, Laufer M, Neulander EZ, Kaver I, Matzkin H
Alpha-adrenergic blockers are an established form of medical treatment for symptomatic benign prostatic hyperplasia (BPH). Several medications of the class are available, each with its own characteristics. The authors attempted to define the differences between the currently available medications (Terazosin, Doxazosin, Alfuzosin, and Tamsulosin), and to present an evidence-based recommendation for choosing the best treatment option. A literature search was conducted, using Medline queries and the references of review papers, in search of pertinent studies. These included controlled studies comparing the results of treatment with alpha blockers to placebo, or direct comparative studies of alpha blockers, and real life practice, community studies of each of the medications. A similar efficacy emerged from the reviewed articles, but with a different adverse events profile. A higher rate of vasodilatatory, cardiovascular side effects (dizziness, fatigue, and hypotension) was observed with terazosin and doxazosin, when compared with the uroselective alfuzosin and tamsulosin. Of the latter two, hypotension was more frequent with alfuzosin, while ejaculatory dysfunction was more frequent with tamsulosin. In conclusion, each of the four medications is a possible treatment option for BPH, but we believe alfuzosin and tamsulosin are the better choice. In light of an identical efficacy, these medications offer better tolerability, and ease of use of a once daily treatment without dose titration. The choice between the two should be tailored to the individual patient, with alfuzosin associated with hypotensive side effects, and tamsulosin causing ejaculatory dysfunction.
High dose norepinephrine-induced apoptosis in cultured rat cardiac fibroblast.
Int J Cardiol. 2008 Jul 31;
Lai KB, Sanderson JE, Yu CM
BACKGROUND: Prolonged sympathetic activation is damaging to the heart. Recent findings suggest that norepinephrine (NE) may contribute to the apoptotic cardiac cell loss. This study investigated high doses NE apoptotic effect on cardiac fibroblasts (CF) culture and compared the anti-apoptotic effect of alpha and beta (selective and non-selective) adrenergic receptor antagonists. METHODS AND RESULTS: Rat CF were cultured in the presence of NE (1 to 100 microM) for 48 h. bax and bcl(XL) genes expression were measured by real-time quantitative PCR method. Cell viability percentage, apoptotic cell percentage and caspase 3 activity was measured by MTT assay, flow cytometric method and caspase 3 flurogenic assay kit respectively. NE (100 microM) increased bax gene expression by 1.96+/-0.96 fold while bcl(XL) gene decreased by 0.53+/-0.15 fold when compared with the control group (p
Urologiia. 2008 Jan-Feb; 31-2, 34-5
Pavlov VN, Kazikhinurov AA, Ishemgulov RR, Mustafin AT
To determine microcirculation in the wall of the urinary bladder in prostatic adenoma, we used a laser analyzer of capillary circulation LAKK-01. Two groups participated in the trial: 105 males with stage II prostatic adenoma (the study group) and 25 volunteers (the control group). We estimated normal parameters of microcirculation in the wall of the bladder. In stage II prostatic adenoma the above microcirculation decreased to a subcritical perfusion level. Significantly earlier and complete recovery of microcirculation was observed in patients who had taken cardura (Pfizer) in a dose 2 mg/day for 3 months after transurethral resection of prostatic gland. Thus, 2 mg/day cardura (Pfizer) in patients with prostatic adenoma of stage II after TUR of the prostate promotes early and effective recovery of microcirculation.
Urol Int. 2008; 81(1): 101-6
Demir O, Esen EC, Murat N, Aslan G, Gidener S
It has been well established that erectile dysfunction (ED) is a common incident in patients with benign prostate hyperplasia. Animal models have been described to investigate the relationship between bladder obstruction and ED. In this study, we aimed to investigate whether partial bladder outlet obstruction (PBOO) induces changes in the contraction and relaxation response of corpus cavernosum smooth muscle (CCSM) of the penis in the rabbit model. Partial bladder obstruction was performed in rabbits as previously described. After 2 and 4 weeks of follow-up, control, sham-operated (2- and 4-week duration) and partial bladder outlet obstructed (obstruction of 2- and 4-week duration) rabbits were sacrificed and their bladder masses determined. Then CCSM tissue was obtained. Contraction responses induced by 124 mM KCl, phenylephrine (10(-6) to 10(-4)M) and relaxation responses induced by doxazosin (10(-7) to 10(-5)M) in CCSM of rabbits were determined. The obtained contraction and relaxation responses of all groups were compared. Bladder weight was significantly higher in PBOO groups than in control and sham-operated rabbits. Contraction responses induced by KCl and phenylephrine were statistically enhanced in the 4-week PBOO groups than controls. However, there was no statistically significant difference in any KCl, phenylephrine and doxazosin responses between 2- and 4-week sham-operated and PBOO groups. The rabbit model of PBOO described for the studies which examine bladder responses is useful for creating bladder outlet obstruction. However, this model is not suitable for the investigation of outlet obstruction-related ED.
Urol Int. 2008; 81(1): 66-71
Prieto L, Romero J, López C, Ortiz M, Pacheco JJ
OBJECTIVE: To evaluate the efficacy of modified-release doxazosin 4 mg in the treatment of patients with acute urinary retention (AUR) due to benign prostate gland hyperplasia (BPH). An evaluation is made of the number of patients recovering spontaneous micturition after catheter removal, micturition quality, and the number of patients suffering new AUR episodes or who require surgery in the 2 years following the first episode. PATIENTS AND METHODS: A randomized, controlled study in males with AUR secondary to BPH. Two groups are formed, administering modified-release doxazosin 4 mg to patients born in even-numbered years, once a day in the morning. Those born in odd-numbered years receive no medication. The catheter is withdrawn 1 month later. Flowmetry is performed, with determination of ultrasonographic postmicturition retention at withdrawal, and after 6, 12 and 24 months. RESULTS: Of the 65 patients included, 47 proved evaluable, and 46 complied with treatment (with exclusion of 1 case due to hypotension). Of the 22 patients treated with doxazosin, 15 (68.86%) presented AUR after 2 years, while 7 (31.2%) showed spontaneous micturition. Of the 24 patients treated with bladder catheterization in the absence of medication, 16 (66.6%) presented AUR after the same period of time, while 8 (33.3%) showed spontaneous micturition. There were no statistically significant differences between the treated and untreated subjects in terms of drug efficacy. Residual flow parameters are described in the population with spontaneous micturition in each stage of the study. CONCLUSION: In our series, treatment with the alpha-blocker doxazosin (4 mg, modified-release formulation), added to bladder catheterization, showed no increased efficacy in AUR treatment versus catheterization alone. Two years after the urinary retention episode, 31.2% of the patients treated with modified-release doxazosin 4 mg, and 33.3% of those with a bladder catheter only were seen to maintain spontaneous micturition.