Chap104 Nonsurgical management of prostate

Combination versus Avodart (Dutasteride) or Tamsulosin (CombAT) Trial - In men with a pretreatment PSA between 1.5 and 10 ng/mL, combination of dutasteride and tamsulosin was more effective than either drug alone. Interestingly,in men with larger prostates, although the tamsulosin effect was rapid, over time dutasteride was the more effective agent. Superiority of combination therapy versus dutasteride was seen from month 3 and versus tamsulosin from month 9 and was maintained for the study duration (P < .001).The full 4-year data will be published soon and are important because longer-term studies are clearly needed to fully evaluate the efficacy of 5α-reductase inhibitor therapy in BPH.

Medical Therapy of Prostatic Symptoms (MTOPS) Trial - The MTOPS trial, a prospective,randomized, double-blind, multicenter, placebocontrolled trial, was established to determine whether medical therapy can prevent or delay the progression of BPH in the long term. The results of the MTOPS trial suggest that the combination of doxazosin and finasteride exerts a clinically relevant, positive effect on rates of disease progression.Men who received combination therapy were significantly less likely to experience BPH progression than those receiving either monotherapy or placebo.

Improvement  by 4

After 9 months, the effect of finasteride is same as of tamsulosin