2-Drug Prostate Therapy ‘Dramatic’

A combination of two widely used drugs can sharply reduce the risk that enlarged prostate glands will get worse, offering millions of men a dramatically more effective way to fend off the most miserable effects of one of the most common male afflictions, researchers reported Wednesday.

The largest and longest study of its kind found the two-drug therapy cut by a surprising two-thirds the likelihood that the condition would progress, sparing many from deteriorating to the point where they could not urinate and needed surgery.

“This reduction in risk is as dramatic as anything you see in medicine,” said Dr. Claus Roehrborn of the University of Texas Southwestern Medical Center in Dallas, who led the study. “This condition affects a huge number of men. This study shows we can prevent what ultimately are the most feared outcomes of the disease.”

The study was published in today’s issue of the New England Journal of Medicine. The five-year experiment with 3,047 patients at 17 hospitals coast to coast was the most ambitious study yet of drug treatments for enlarged prostate. It was backed by the National Institutes of Health.

The two drugs in the study, doxazosin and finasteride, are widely used, but not normally combined, to treat an enlarged prostate. The study was designed to decide if they can be teamed up for a stronger effect. Often, such a drug combination fails to boost effectiveness.

This time it succeeded. On its own, each drug reduced the risk of worsening symptoms by about a third. Together, they worked twice as well, cutting the risk by two-thirds.

Because of the large number of men affected by enlarged prostates and the extra cost of giving two drugs, the treatment should probably be reserved for men at highest risk that the disease will progress, Roehrborn said.