Terazosin Superior To Finasteride For BPH

Abbott Laboratories' alpha blocker Hytrin (terazosin) is more effective than Merck & Co's 5-alpha reductase inhibitor Proscar (finasteride) for relieving the urinary symptoms of benign prostatic hyperplasia, according to the final results of a study published in the New England Journal of Medicine (August 22). Indeed, finasteride was found to be no better than placebo in this regard.

Data from this trial, which was conducted by the US Department of Veterans Affairs under the direction of chief investigator Herbert Lepor, was first released last year (Marketletter September 11, 1995). At that time, Merck noted that the result went against the body of evidence it had compiled in its own clinical trials of the drug, and the firm also observed that Dr Lepor had used the highest dose of Hytrin, compared to standard dose for Proscar.

Dr Lepor stands by his data, noting that "this confirms that not only is there no need to shrink the prostate to relieve symptoms of BPH, but also that shrinking the gland may have no significant effect on symptoms. Patients on finasteride had the expected shrinkage in prostate size, according to the authors of the VA study. Merck began marketing Proscar in 1992 and Abbott entered the market a year later.