Alpha-blocking treatment with alfuzosin in symptomatic benign prostatic hyperplasia: comparative study with prazosin. The PRAZALF Group

Abstract

Alfuzosin, a selective alpha 1-adrenoceptor antagonist which is effective in the symptomatic treatment of benign prostatic hyperplasia (BPH), was compared with prazosin, another drug commonly used for the same purpose. After a 1-week placebo run-in period, 103 patients with day-time frequency > or = 7 or nocturia > or = 2 and peak flow rate < 15 ml/s were randomised to receive either alfuzosin (2.5 mg tid) or prazosin (2 mg bid) for 3 weeks, with a gradual dose increase during the first week, in a double-blind, parallel group, multicentre study. Voiding symptoms, assessed on the basis of the Boyarsky scale and a micturition diary, were significantly improved in both groups, as were urinary flow rates. However, neither the clinical improvement nor the increase in flow rates differed significantly between the 2 groups. The peak flow rate increased similarly with alfuzosin (2.6 +/- 0.6 ml/s) and prazosin (2.9 +/- 0.7 ml/s); the mean flow rate and voided volume increase tended to be more marked with alfuzosin (30 and 22.2% respectively) than with prazosin (20.6 and 6.5%). Clinical safety was good in both groups. All 4 adverse events in the prazosin group but only 1 of the 4 adverse events in the alfuzosin group were related to a decrease in blood pressure. It was concluded that alfuzosin was at least as effective as prazosin in the treatment of symptomatic patients with BPH and the incidence of adverse events related to their vasodilatory properties was lower with alfuzosin.