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In the previously published MTOPS trial (Journal Watch Jan 13 2004), combined therapy with an α-blocker (doxazosin) and a 5α-reductase inhibitor (finasteride) was superior to monotherapy with either agent in patients with benign prostatic hyperplasia (BPH). In this new double-blind trial, researchers randomized 4844 men with BPH and prostate volume ≥30 mm3 to receive the α-blocker tamsulosin (Flomax), the 5α-reductase inhibitor dutasteride (Avodart), or combined therapy. The maker of dutasteride sponsored the trial.
At 2 years, improvement on a standardized 35-point symptom score was significantly greater with combined therapy than with dutasteride or tamsulosin monotherapies (mean decrease, 6.2 vs. 4.9 and 4.3 points from a mean baseline sc…