Efficacy and Safety of Long-Term Treatment with the Dual 5α-Reductase Inhibitor Dutasteride in Men with Symptomatic Benign Prostatic Hyperplasia

Debruyne, F.; Barkin, Jack; Erps, P. Van; Reis, Mário; Tammela, Teuvo L.J.; Roehrborn, Claus G.

doi:10.1016/j.eururo.2004.05.008

Cited by 215 publications

(173 citation statements)

References 17 publications

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“…These events are more prominent in the first months of therapy, and the incidence tends to diminish with time. [78][79][80][81] The Alfuzosin-Finasteride (ALFIN) study demonstrated that alfuzosin had little or no impact on sexual function, whereas finasteride and combination therapy (alfuzosin and finasteride) caused impairment of erectile and ejaculatory function. 82,83 These findings have also been replicated in the larger scale, placebo-controlled Medical Therapy of Prostatic Symptoms study.…”

Section: Luts and Ed: Effects On Clinical Managementmentioning

confidence: 99%

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management

2011

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There is strong evidence from multiple epidemological studies that lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are correlated, independent of age or comorbidities as diabetes or hypertension. Although a direct causal relationship is not established yet, four pathophysio logical mechanisms can explain the relationship. These include alteration in nitric oxide bioavailability, a1-adrenergic receptor hyperactivity, pelvic atherosclerosis and sex hormones. This association has different clinical implications on the management of both disorders. Men seeking care for one condition should always be screened for complaints of the other condition. Sexual function should be assessed and discussed with the patient when choosing the appropriate management strategy for LUTS, as well as when evaluating the patient's response to treatment. Multiple large clinical trials have shown an improvement in LUTS after phosphodiesterase-5 (PDE5)-inhibitor treatment. PDE5 inhibitors show promise as a future treatment for LUTS, either in conjunction with existing therapies or as a primary treatment. There may be a potential therapeutic role for testosterone in LUTS treatment in cases of testosterone deficiency that needs to be investigated. Much further investigation is required, but it is evident that the association between LUTS and ED is fundamental for future therapies and possible preventative strategies.

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Section: Luts and Ed: Effects On Clinical Managementmentioning

confidence: 99%

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management

2011

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“…The decrease in DHT levels with 5ARI was accompanied by a reciprocal increase in serum testosterone levels. Serum testosterone had increased by a mean of 25% at month 48 in the dutasteride treatment groups [ 7,9,12,30,35 ] . Mean and median testosterone values remained within the normal physiological range [ 12,30,35 ] .…”

Section: T H E D I G I T R a T I O A N D P R O S T A T E V O L U M E mentioning

confidence: 99%

Dutasteride, who is it more effective for? Second to fourth digit ratio and the relationship with prostate volume reduction by dutasteride treatment

Kim

et al. 2012

BJU International

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E 8 5 7What ' s known on the subject? and What does the study add? The second to fourth digit ratio (hereafter the digit ratio) of the right hand is related to the activity of the androgen receptor. Five α -reductase inhibitor (5ARI) reduces the prostate volume of patients with BPH. In terms of prostate volume reduction, large-scale placebo-controlled studies show that patients with BPH do not always respond well to 5ARI treatment.Patients with a higher digit ratio respond well to dutasteride treatment compared to those with a lower digit ratio. These results suggest that the digit ratio might be a predictor of the response to dutasteride treatment. OBJECTIVE• To investigate the relationship between second to fourth digit ratio (hereafter the digit ratio) and prostate volume reduction by dutasteride treatment. PATIENTS AND METHODS• A total of 142 men aged ≥ 40 years with a clinical diagnosis of benign prostatic hyperplasia and an enlarged prostate (prostate volume ≥ 30 mL) were prospectively enrolled.• Before prostate-specifi c antigen (PSA) level determination and transrectal ultrasonography (TRUS), the lengths of the second and fourth digits of the right hand were measured by an investigator using a digital vernier calliper.• Using TRUS, pre-and post-treatment prostate volume (PV1 and PV2) were measured by an uroradiologist who was unaware of fi nger lengths. We investigated the change in prostate volume and PSA level at least 6 months after the initiation of dutasteride therapy. RESULTS• When the patients were divided into two groups according to digit ratio (A: digit ratio < 0.95, n = 71; B: digit ratio ≥ 0.95, n = 71), there was a greater reduction in prostate volume in group B compared to group A (PV2 -PV1: − 9.4 mL vs − 13.2 mL, P = 0.042; [ PV2 -PV1 ] /PV1: − 17.5% vs − 24.5%, P = 0.027; [ PV2 -PV1 ] /duration: − 1.1 mL/month vs − 1.6 mL/month, P = 0.041; [ PV2 -PV1 ] /PV1/duration: − 2.0%/ month vs − 3.0%/month, P = 0.016).• Signifi cant negative correlations were found between the digit ratio and reduction rate ( [ PV2 -PV1 ] /duration: r = − 0.165, P = 0.049; [ PV2 -PV1 ] /PV1/duration: r = − 0.191, P = 0.023). CONCLUSIONS• Patients with higher digit ratios respond well to dutasteride treatment.• The results obtained in the present study suggest that the digit ratio is a predictor of the response to dutasteride treatment. Dutasteride, who is it more effective for? Second to fourth digit ratio and the relationship with prostate volume reduction by dutasteride treatment KEYWORDS

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“…Dutasteride was well tolerated, and the reduction in risk of acute urinary retention and in the need of BPH-related surgery seen in the double-blind phase was maintained throughout the open-label phase. [56] In a recently carried out double-blind, randomized clinical trial, dutasteride (0.5 mg/ day) has also been found to be better than Þ nasteride (5 mg/day) in improving symptom score, maximal urinary ß ow rate, and quality of life when given over a period of 12 weeks.…”

Section: Finasteridementioning

confidence: 99%

Current status of 5α-reductase inhibitors in the treatment of benign hyperplasia of prostate

Kumar¹,

Wahane²

2008

Indian J Med Sci

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Benign prostatic hyperplasia (BPH) is a common problem in aging menof BPH include increased urinary frequency, urgency, intermittency; nocturia; decreased force of stream; hesitancy and straining that are usually associated with complications such as acute urinary retention, urinary incontinence, recurrent urinary tract infection, hematuria, renal failure, and bladder stone. [4][5][6][7][8][9] The primary goal for treating symptomatic BPH is to improve urine ß ow, for which both surgical and nonsurgical approaches are available. Surgical treatment for BPH is usually indicated in recurrent cases of urinary retention, urinary tract infections, hematuria, and in azotemia.

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Efficacy and Safety of Long-Term Treatment with the Dual 5α-Reductase Inhibitor Dutasteride in Men with Symptomatic Benign Prostatic Hyperplasia

Cited by 215 publications

References 17 publications

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management

Dutasteride, who is it more effective for? Second to fourth digit ratio and the relationship with prostate volume reduction by dutasteride treatment

Current status of 5α-reductase inhibitors in the treatment of benign hyperplasia of prostate

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