THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Thursday, August 22, 1996 TAG: 9608220401
SECTION: FRONT PAGE: A8 EDITION: FINAL
SOURCE: ASSOCIATED PRESS
DATELINE: BOSTON LENGTH: 55 lines
The first head-to-head comparison of the nation's two most popular medicines for prostate trouble found that one gives significant relief while the other is virtually worthless.
The two medicines, Hytrin and Proscar, are taken by millions of older men to relieve the symptoms of an enlarged prostate gland. The study found that Hytrin eases men's discomfort by about one-third, while Proscar works no better than dummy sugar pills.
For the majority of patients, Proscar is no more than ``an expensive placebo,'' said Dr. Herbert Lepor of New York University Medical Center, the study's director. Prostate drugs generally cost $30 to $45 a month.
The study was financed by Merck & Co., which makes Proscar, and Abbott Laboratories Inc., the maker of Hytrin. It was conducted on 1,229 men at Veteran Affairs hospitals.
Although both companies approved the study's design, Merck discounted its significance as publication approached in today's issue of the New England Journal of Medicine.
Dr. Glenn Gormley, a Merck research official, said that in hindsight, the study was not set up properly to answer the question of which drug is better. He said experts now know that Proscar works only in men whose prostate glands are larger than those typically seen in the study. Merck distributed copies of an article in next month's issue of the journal Urology to support that conclusion.
That analysis, by Dr. Claus G. Roehrborn of the University of Texas Southwestern Medical Center in Dallas, pooled the results of six studies of Proscar, including the VA study. Taken together, they suggest the medicine indeed works, but size matters: The larger the prostate, the more Proscar helps.
``Finasteride (the active ingredient in Proscar) is clearly superior to placebo and clinically effective in men with prostates over 40 cubic centimeters,'' Roehrborn said. ``It's a stunning and exciting result.''
The average size of men's prostates in the VA study was 37 cubic centimeters.
About two-thirds of American men suffer enlargement of the walnut-size prostate gland by the time they reach their 60s, and the condition grows more common with age.
The enlarged prostate gland squeezes the urethra, making it difficult to urinate. Often the bladder doesn't empty completely, so men are seized with an urgent need to go at inconvenient moments, often in the middle of the night.
Until a few years ago, surgery was the only solution, but it carries a small risk of impotence or partial incontinence.
KEYWORDS: PROSTATE HYTRIN PROSCAR DRUG TREATMENT by CNB