PURPOSE: We determine the effect of placebo, @entity585 , @entity7477 and a combination of drugs on bother due to symptoms, quality of life and @entity1 perception of improvement, and identify baseline clinical factors that predict clinical response to medical therapy. MATERIALS AND METHODS: A total of 1,229 subjects with clinical @entity1067 ( @entity1067 ) were randomized to 1 year of placebo, @entity585 , @entity7477 or drug combination. The primary outcome measures were American Urological Association (AUA) symptom score and peak flow rate. Relevant secondary outcome measures were symptom problem score, @entity1067 impact score and global rating of improvement. RESULTS: Group mean differences in symptom problem and @entity1067 impact scores between the @entity585 versus placebo, and @entity7477 versus combination groups were not statistically or clinically significant. Group mean differences in all outcome measures were highly statistically significant between the @entity7477 and @entity585 , and combination and @entity585 groups. The percentage of subjects who rated improvement as marked or moderate with placebo, @entity585 , @entity7477 and combination was 39, 44, 61 and 65%, respectively. In the subsets of @entity1 in the placebo, @entity585 , @entity7477 and combination groups with prostates greater than 50 cm.3 group mean decrease from baseline in AUA symptom score was -2.5, -3.6, -6 and -7, group mean increase in peak flow rate was 0.6, 2.7, 3.6 and 3.7 ml. per second, group mean decrease in symptom problem score was -2.2, - 1.9, -3.1 and -4.5, and group mean decrease in @entity1067 impact score was -0.6, -0.3, -1.1 and -1.5, respectively. A correlational analysis failed to show a significant relationship between baseline prostate volume and treatment response to @entity585 . There was a significant but weak relationship between change in AUA symptom score and peak flow rate in the @entity585 and combination groups. The symptom responses with @entity7477 were independent of baseline peak flow rate. CONCLUSIONS: In @entity1 with clinical @entity1067 @entity585 and placebo are equally effective, while @entity7477 and combination are significantly more effective. In @entity1 with clinical @entity1067 and large prostates the advantage of @entity585 over placebo in terms of symptom reduction, impact on bother due to symptoms and quality of life is small at best, while the advantage of @entity7477 and combination over @entity585 and placebo is highly significant. Baseline prostate volume was not a predictor of response to @entity585 in the overall study population. On the basis of our results alpha1 blockers, such as @entity7477 , should be first line medical treatment for @entity1067 .

The impact of medical therapy on bother due to symptoms, quality of life and global outcome, and factors predicting response. Veterans Affairs Cooperative Studies XXXX Study Group.

@entity1 :: ('9606', 'Species') :: ['patient', 'men'] @entity1067 :: ('MESH:D011470', 'Disease') :: ['benign prostatic hyperplasia', 'BPH'] @entity7477 :: ('MESH:C041226', 'Chemical') :: ['terazosin'] @entity585 :: ('MESH:D018120', 'Chemical') :: ['finasteride']
@entity1067 :: (MESH:D011470,Disease) :: ['Benign Prostatic Hyperplasia']
