Meta-analysis of randomized, placebo-controlled clinical trials of terazosin

Six randomized clinical trials over the last decade have compared the medical therapy terazosin with placebo for treating clinical benign prostatic hyperplasia (BPH). The findings for the 872 men in these trials provide an opportunity to investigate the heterogeneity of the ef fects seen in the individual studies as expressed by changes in symptoms ox peak urinary flow rates. A formal meta-analysis. using the approach of Hedges and Olkin (Academic Press, 1991) employed data from all t-erazosin phase III trials conducted in North America and internationally over the last decade. A pooled analysis was also undertaken on the combined data set. There were consistent effects across all six trials for terazosin and improvements in peak urinary flow rate and Boyarsky obstructive, irritative, and total symptom scores, The overall effect of terazosin was to produce an effect of 0.40 (95% CI 0.25, 0.54) compared to placebo, indicating a large and statistically significant improvement in peak urinary flow rate. Similarly large effects were noted in favor of terazosin for the Boyarsky obstructive score (0.41; 95% CI 0.27, 0.56) and the Boyarsky irritative score (0.33; 95% CI 0.19, 0.48). This meta-analysis confirms that terazosin is an effective therapeutic agent in the treatment of clinical BPH and that the therapeut ic value of terazosin was well established from the results of early studies. In light of advancing knowledge of BPH, it may be worthwhile to further invest igate the effect of terazosin in terms of different BPH symptom subsets and quality-of-life domains.