전립선비대증에 대한 Doxazosin의 치료효과
Doxazosin in the Symptomatic Treatment of Benign Prostatic Hyperplasia
정병하, 정현직, 홍성준, 이무상,
소속 상세정보
정병하 ( )
연세대학교 의과대학 비뇨기과학교실
정현직 ( )
연세대학교 의과대학 비뇨기과학교실
홍성준 ( )
연세대학교 의과대학 비뇨기과학교실
이무상 ( )
연세대학교 의과대학 비뇨기과학교실
KMID : 0358319990400050607
Abstract
서론
전립선비대증은 인구가 노령화됨 에 따라 치료가 필요한 대상이 점차 늘고 있는 추세이며
전세계적으로 주요한 보건문제로 대두되고 있다. 전립선비대증에 대한 치료는 내과적 약물
치료부터 비침습적치료, 그리고 수술적 치료까지 여러 가지 방법이 있으며 이중에서 어떠한
치료를 시행하느냐 하는 것은 여러 가지 요인이 복합적으로 작용한다. 최근에 치료 효과면
에서 수술적 치료에는 못 미치지만 합병증이 적고 효과가 비교적 좋아서 약물치료에 대한
선택이 꾸준히 늘고 있는 추세이다. 약물치료 중에서 알파 1 차단제는 이미 선진국에서 전
립선비대증에 대한 치료효과가 검증되어 전립선비대증의 일차치료로서 받아들여지고 있다.
이에 저자들은 증상이 있는 국내 전립선비대증 환자를 대상으로 long acting 알파 1 차단
제인 doxazosin의 효과 및 안전성에 관하여 알아보고자 하였다.
Purpose : This study set out to investigate the safety and efficacy of doxazosin
treatment in symptomatic patients with benign prostatic hyperplasia(BPH) in Korea.
Materials and Methods : A total of 237 male patients aged 50 or over with clinical
evidence of BPH were enrolled into this 12-week, open, baseline-controlled,
dose-response study. A run-in period of 2 weeks placebo treatment was followed by 10
weeks of doxazosin treatment. The initial dose was 1㎎ per day which, at 2-week
intervals, could have been titrated up to 2, 4, or 8㎎ per day. Efficacy, in terms of
International Prostate Symptom Score(I-PSS) and blood pressure(BP), was assessed
from Week 6 onwards.
Results : A total of 180 patients(mean age 65.3 years) completed the study, with the
most common reason for withdrawal being lost to follow-up(35 cases); four patients
were withdrawn due to adverse events. Mean I-PSS score was reduced by 48.8%(from
21.5 at baseline to 11 at completion). Subset analysis of normo- or hypertensive patients
showed that in the 26 hypertensive patients mean systolic BP was reduced by
12.3%(-19mmHg) and mean diastolic BP by 13.7%(-14mmHg), whereas in normotensive
patients the reductions were 4.0%(-5mmHg) and 1.9%(-1.5mmHg), respectively. No
differences in I-PSS improvements were seen between these two groups. The effects of
age were also investigated and showed no significant differences in the changes in blood
pressure for older patients(≥65 years; n=91) compared with younger
patients(7.5/5.0mmHg compared with 6.5/5.0mmHg). There were no differences in I-PSS
improvement. Twenty eight adverse events were reported by 16 patients, the most
commonly reported events being dizziness, postural hypotension, and headache.
Conclusions : The effectiveness and safety of doxazosin in the treatment of BPH was
confirmed in this Korean population, with significant improvements in I-PSS regardless
of patient age and blood pressure at baseline. The baseline I-PPS was higher than is
commonly seen in European populations, indicating a greater disease severity.
키워드
Alpha 1 antagonist; Benign prostatic hyperplasia; Doxazosin;
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