Atorvastatin Treatment for Men with Lower Urinary Tract Symptoms and Benign Prostatic Enlargement

Mills, Ian W.; Crossland, Anna; Patel, Anup; Ramonas, Henrikas

doi:10.1016/j.eururo.2007.02.032

Cited by 53 publications

(51 citation statements)

References 25 publications

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“…Baseline PSA level was 0.08 ng/mL lower in the treatment arm than the placebo control arm. After 26 weeks of treatment with atorvastatin, there was a mean decrease of 0.1 ng/mL compared to a mean decrease of 0.0 ng/mL in the placebo control group (59). However, these results were not statistically significant but provide supporting evidence of the role that statins may play in decreasing PSA levels.…”

Section: Impact Of Statin Therapy On Psacontrasting

confidence: 52%

“…In 2007, Mills et al published a phase 2, double-blind, randomized placebo controlled clinical trial evaluating atorvastatin treatment for men with lower urinary tract symptoms and benign prostatic enlargement (59). Included among many of the endpoints were differences in PSA levels among subjects after 6 months of treatment with 80 mg daily of atorvastatin or placebo.…”

Section: Impact Of Statin Therapy On Psamentioning

confidence: 99%

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Prostate specific antigen reduction following statin therapy: Mechanism of action and review of the literature

Mener

2010

IUBMB Life

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SummaryProstate specific antigen (PSA) is a serine protease that is exclusively produced in the prostate, and its detection is the only laboratory test available for screening men for prostate cancer (PC). The interpretation of the assay is difficult since it is specific for prostate tissue and cellular growth, but not for PC. Pharmacologic therapy for hyperlipidemia, such as statins, may influence prostate cellular growth and subsequently PSA levels in patients. Dysregulated cellular growth in the prostate is mediated by inhibiting the rate-limiting pathway step in cholesterol synthesis, thereby decreasing isoprenylate intermediates, decreasing cholesterol rich cellular membrane domains, and down-regulating androgen and estrogen receptors. Statins, with variable efficacy, have been previously shown to inhibit cellular inflammation, angiogenesis, proliferation, migration/adhesion, and invasion, while promoting apoptosis in prostate cells by inhibiting the conversion of HMG-CoA to mevalonate. An individual statin's molecular structure, need for enzymatic conversion, bioavailability, and peripheral tissue concentration may partially account for differing properties. By inhibiting prostatic cellular growth and promoting apoptosis, statins may subsequently decrease PSA levels, an effect recently observed in cohorts. There is scientific and clinical evidence supporting the observations that statins are associated with an overall reduction in serum PSA in men, when used for greater than 6 months, and especially when used for greater than 2 years. 2010 IUBMB IUBMB Life, 62(8): 584-590, 2010

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Section: Impact Of Statin Therapy On Psacontrasting

confidence: 52%

Section: Impact Of Statin Therapy On Psamentioning

confidence: 99%

Prostate specific antigen reduction following statin therapy: Mechanism of action and review of the literature

Mener

2010

IUBMB Life

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“…For example, short-term lovastatin treatment does not seem to have any effect on IPSS, PV or PSA levels in men with prostatic enlargement due to presumed BPH and lipidemia [22]. Moreover, a large, double-blind, randomized, placebo-controlled clinical study found that atorvastatin had no effects on IPSS or PV over 6 months in 350 patients with presumed BPH who had serum LDLs in the range of 100-190 mg/dl [23]. However, in the present study, we observed positive results and found that both simvastatin and atorvastatin significantly reduced the serum levels of TG, TC, and LDL-C and increased the serum levels of HDL-C; these findings are consistent with those previously described [24].…”

Section: Discussionmentioning

confidence: 98%

The effects of statins on benign prostatic hyperplasia in elderly patients with metabolic syndrome

et al. 2015

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“…In contrast Mills et al, assessed the efficacy of atrovastatin in the treatment of LUTS and prostate enlargement in a large, double blind, placebo-controlled trial. The results of these previous studies are controversial; while treatment with simvastatin achieved a 38-40% clinical response in the first study (24), treatment with atrovastatin did not show an effect on urinary symptoms, flow rate, quality of life, or prostate size and morphology and PSA in the second (25). Given the similarities in the pharmacological profile between simvastatin and atrovastatin it could be easily assumed that the effects on observed in the study of Marino et al, are more likely to be attributed to the mepartricin whose efficacy in the treating of BPH related symptoms was further investigated (26)(27)(28).…”

Section: Commentsmentioning

confidence: 95%

“…Only two clinical trials (24,25) to date have addressed the potential use of statins in the treatment of men with LUTS and BPH. In the study of Marino et al, simvastatin was used along with mepartricin, a polyene macrolide antibiotic with unknown composition, for the treatment of symptomatic BPH in a small sample of patients.…”

Section: Commentsmentioning

confidence: 99%

The effects of lovastatin on conventional medical treatment of lower urinary tract symptoms with finasteride

Stamatiou

Zaglavira

Skolarikos³

et al. 2008

Int. braz j urol.

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Objective: To explore whether or not statins have any impact on the progression of components of benign prostatic hyperplasia (lower urinary tract symptoms severity, prostate volume and serum prostate specific antigen (PSA) when combined with other agents inhibiting growth of prostate cells. Materials and Methods:This was a preliminary, clinical study. Eligible patients were aged > 50 yrs, with International Prostate Symptom Score (IPSS) between 9 and 19, total prostate volume (TPV) > 40 mL, and serum PSA > 1.5 ng/mL. Patients were divided in two groups: those with and those without lipidemia. After selection, eligible BPH patients with lipidemia (n = 18) were prescribed lovastatin 80 mg daily and finasteride 5 mg daily, while eligible patients without lipidemia (n = 15) were prescribed only finasteride 5 mg daily. IPSS, TPV and serum PSA were evaluated at end point (4 months).Results: There was no difference between the two groups on the primary end point of mean change from baseline in IPSS (p = 0.69), TPV (p = 0.90) and PSA (p = 0.16) after 4 months of treatment. Conclusions: Short-term lovastatin treatment does not seem to have any effect on IPSS, TPV and PSA in men with prostatic enlargement due to presumed BPH.

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Atorvastatin Treatment for Men with Lower Urinary Tract Symptoms and Benign Prostatic Enlargement

Cited by 53 publications

References 25 publications

Prostate specific antigen reduction following statin therapy: Mechanism of action and review of the literature

Prostate specific antigen reduction following statin therapy: Mechanism of action and review of the literature

The effects of statins on benign prostatic hyperplasia in elderly patients with metabolic syndrome

The effects of lovastatin on conventional medical treatment of lower urinary tract symptoms with finasteride

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