1786 A 5 YEAR STUDY OF THE USE 5 – ALPHA REDUCTASE INHIBITORS IN MEN WITH BENIGN PROSTATIC HYPERPLASIA: FINASTERIDE HAS EQUAL EFFICACY AND PROSTATE VOLUME REDUCTION BUT HAS LESS SEXUAL SIDE EFFECTS AND BREAST ENLARGEMENT THAN DUTASTERIDE

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Medical and Hormonal Therapy1 Apr 20101786 A 5 YEAR STUDY OF THE USE 5 – ALPHA REDUCTASE INHIBITORS IN MEN WITH BENIGN PROSTATIC HYPERPLASIA: FINASTERIDE HAS EQUAL EFFICACY AND PROSTATE VOLUME REDUCTION BUT HAS LESS SEXUAL SIDE EFFECTS AND BREAST ENLARGEMENT THAN DUTASTERIDE Steven Kaplan, Doreen Chung, Richard Lee, Scott Melamed, and Alexis Te Steven KaplanSteven Kaplan More articles by this author , Doreen ChungDoreen Chung More articles by this author , Richard LeeRichard Lee More articles by this author , Scott MelamedScott Melamed More articles by this author , and Alexis TeAlexis Te More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1697AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES 5–alpha reductase inhibitors (5–ARI) have been widely used in the management of men with benign prostatic hypertrophy (BPH). To date there have been no published comparative studies between finasteride (type 2 5–ARI) and dutasteride (types 1 and 2 5–ARI). This study represents the largest and longest data set comparing the safety, efficacy and prostate size reduction of both finasteride (FIN) and dutasteride (DUT). METHODS A retrospective analysis of 378 consecutive men treated with 5–ARI monotherapy between January 2004 – September 2009 (197 on FIN and 211 on DUT) was performed. Parameters of evaluation included were: 1) efficacy: International Prostate Symptom Score (IPSS), peak flow rate (Qmax), postvoid residual urine (PVR), prostate specific antigen (PSA), prostate volume reduction (PV), IIEF and ejaculatory function and 2) adverse events (AE). Men were evaluated at 3 months, 1 year and yearly thereafter. RESULTS Mean age of the group was 58.7 +/- 6.7 years. Maintenance of therapy at 5 years was 57.4% and 42.5% for FIN and DUT, respectively. Changes in IPSS, Qmax, PVR, PV, and PSA were similar for both groups at both 1 and 5 years, irrespective of baseline prostate volume (Table 1). The incidence of erectile dysfunction, ejaculatory dysfunction and decreased libido resulting in withdrawal from therapy was significantly higher in the DUT (5.1%, 2.4%, 2.7%) versus FIN (2.1%, 1.8%, 1.4%, respectively) group (p<0.01). In addition, self reported breast tenderness and/or enlargement were significantly greater in the dutasteride (3.5%) versus the finasteride (1.2%) group (p<0.01). Baseline FIN (n = 197) 5 year FIN (n = 113) Baseline DUT (n = 181) 5 year DUT (n = 77) IPSS 15.9 9.6 16.3 9.9 Qmax (ml/sec) 10.4 9.5 10.3 9.5 PVR (ml) 68 32 59 34 PV (ml) 58.7 47.2 (-19.6%) 57.6 46.4 (-19.4%) PSA (ng/ml) 4.5 2.3 (-48.9%) 4.8 2.4 (-50%) IIEF 18.7 16.3 18.9 15.4 CONCLUSIONS In properly selected patients, both FIN and DUT are effective therapies for the management of lower urinary tract symptoms secondary to BPH. However, DUT resulted in significantly more sexual side effects and breast complications than FIN. These long-term results suggest that FIN may be a more optimal choice as primary therapy than DUT. New York, NY© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e692-e693 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Steven Kaplan More articles by this author Doreen Chung More articles by this author Richard Lee More articles by this author Scott Melamed More articles by this author Alexis Te More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...