高血圧と前立腺肥大症を有する男性患者の下部尿路症状に対するサブタイプ非選択的ならびに選択的 α₁遮断薬の後ろ向き比較検討

抄録

Although doxazosin, a subtype nonselective α₁-adrenoceptor antagonist, has been shown to improve hypertension and benign prostatic hyperplasia, it is recommended that the two disease entities should be treated independently with the best available drugs. Therefore, we compared the efficacy and safety of three α₁-adrenoceptor antagonists with different selectivity for the α₁-adrenoceptor subtypes ; doxazosin, silodosin and tamsulosin, for lower urinary tract symptoms in male patients with hypertension and benign prostatic hyperplasia. In a retrospective study, the medical records of 58 hypertensive patients with benign prostatic hyperplasia treated with doxazosin, silodosin plus amlodipine, or tamsulosin plus amlodipine between January 2013 and December 2015 were evaluated. International Prostate Symptom Score (I-PSS), QOL score and maximum urinary flow rate were assessed at baseline and after a 12-week treatment period in all patients. Treatment with doxazosin and amlodipine resulted in a significant reduction in blood pressure from baseline. Doxazosin, silodosin and tamsulosin were similarly effective in improving total I-PSS, QOL score and maximum urinary flow rate. While dizziness was reported in 1 of the 21 patients receiving doxazosin, abnormal ejaculation was reported with subtype selective α₁-adrenoceptor antagonists but not with doxazosin. Our data demonstrate that all three α₁ -adrenoceptor antagonists have similar clinical efficacy and that there are slight differences in the adverse event profiles of these drugs. These findings suggest that doxazosin is a safe and effective treatment in hypertensive patients with benign prostatic hyperplasia.