Finasteride for benign prostatic hyperplasia

Tacklind, James; Fink, Howard A; MacDonald, Roderick; Rutks, Indulis; Wilt, Timothy J

doi:10.1002/14651858.cd006015.pub3

Cited by 71 publications

(46 citation statements)

References 76 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The reduced rates of BPH-related events, comprised primarily of lower urinary tract symptoms, in finasteride-treated patients over an extended period of follow-up are both consistent with and extend the findings from the main report of the PCPT results (5) and from other studies (16,17). A Cochrane review by Tacklind and colleagues examined results from multiple studies with different metrics for BPH symptoms and different finasteride doses (11). They found that finasteride improved symptoms in general after one year.…”

Section: Articlesupporting

confidence: 68%

See 1 more Smart Citation

Long-term Consequences of Finasteride vs Placebo in the Prostate Cancer Prevention Trial

Unger

Till

Thompson

et al. 2016

JNCI J Natl Cancer Inst

View full text Add to dashboard Cite

Background: Finasteride has been found to reduce the risk of low-grade prostate cancer but to have no impact on overall survival. The long-term adverse and beneficial consequences of finasteride have not been examined. Methods: We used a linkage between data from the Prostate Cancer Prevention Trial (PCPT) and Medicare claims. Patients were examined by randomized study arm (finasteride vs placebo for 7 years) for long-term consequences of the intervention, including cardiac, endocrine, and sexual dysfunction, depression, diabetes, and benign prostatic hyperplasia (BPH)-related events. To examine time to events, we used cumulative incidence and Cox regression, adjusting for covariates. All statistical tests were two-sided. Results: A total of 13 935 of 18 880 participants (73.8%) in the PCPT were linked to Medicare claims, with median Medicare follow-up assessment time of 16 years from trial registration. There were no differences between finasteride and placebo participants with respect to important baseline factors or amount of Medicare follow-up assessment time. Finasteride patients had a 10% higher risk of new claims for depression (hazard ratio [HR] ¼ 1.10, 95% confidence interval [CI] ¼ 1.01 to 1.19, P ¼ .04) and a 6% lower risk of procedures for BPH-related events (primarily lower urinary tract symptoms; HR ¼ 0.94, 95% CI ¼ 0.89 to 1.00, P ¼ .03). No other differences were found in rates of long-term consequences of intervention in the two study arms. Conclusions: Finasteride use is associated with reduced need for procedures for relief of BPH-related events and a modest increase in depression. Overall, there is little need to worry about long-term noncancer consequences of finasteride use in those who use it for treatment of symptomatic BPH, hair growth, or prevention of cancer.

show abstract

Section: Articlesupporting

confidence: 68%

“…Despite these recent findings, finasteride is not labeled with a prostate cancer indication and is rarely used for prostate cancer prevention today (9,10). Instead, finasteride at the dose used in the PCPT is most commonly used to treat symptoms of benign prostatic hyperplasia (BPH) (11).…”

mentioning

confidence: 99%

Long-term Consequences of Finasteride vs Placebo in the Prostate Cancer Prevention Trial

Unger

Till

Thompson

et al. 2016

JNCI J Natl Cancer Inst

View full text Add to dashboard Cite

show abstract

“…Although several aspects of physiopathology of BPH are still unknown, many important achievements were observed in the last decades and some risk factors for the worsening of symptoms and AUR were identified through longitudinal studies, as age, prostatic volume, presence of more severe symptoms and higher PSA values (20,21). Finasteride diminishes significantly symptoms, the occurrence of AUR episodes and the need of surgery (22). Although there is a stigma about the impact on sexual health, the percentage of these side effects is low (22).…”

Section: Discussionmentioning

confidence: 99%

“…Finasteride diminishes significantly symptoms, the occurrence of AUR episodes and the need of surgery (22). Although there is a stigma about the impact on sexual health, the percentage of these side effects is low (22).…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness analysis of medical treatment of benign prostatic hyperplasia in the Brazilian public health system

et al. 2012

View full text Add to dashboard Cite

ARTICLE INFO _________________________________________________________ ___________________Objective: To perform a cost-effectiveness analysis of medical treatment of benign prostatic hyperplasia (BPH) under Brazilian public health system perspective (Unified Health System -"Sistema Único de Saúde (SUS)"). Material and Methods:A revision of the literature of the medical treatment of BPH using alpha-blockers, 5-alpha-reductase inhibitors and combinations was carried out. A panel of specialists defined the use of public health resources during episodes of acute urinary retention (AUR), the treatment and the evolution of these patients in public hospitals. A model of economic analysis(Markov) predicted the number of episodes of AUR and surgeries (open prostatectomy and transurethral resection of the prostate) related to BPH according to stages of evolution of the disease. Brazilian currency was converted to American dollars according to the theory of Purchasing Power Parity (PPP 2010: US$ 1 = R$ 1.70). Results: The use of finasteride reduced 59.6% of AUR episodes and 57.9% the need of surgery compared to placebo, in a period of six years and taking into account a treatment discontinuity rate of 34%. The mean cost of treatment was R$ 764.11 (US$449.78) and R$ 579.57 (US$ 340.92) per patient in the finasteride and placebo groups, respectively. The incremental cost-effectiveness ratio (ICERs) was R$ 4.130 (US$ 2.429) per episode of AUR avoided and R$ 2.735 (US$ 1.609) per episode of surgery avoided. The comparison of finasteride + doxazosine to placebo showed a reduction of 75.7% of AUR episodes and 66.8% of surgeries in a 4 year time horizon, with a ICERs of R$ 21.191 (US$ 12.918) per AUR episodes avoided and R$ 11.980 (US$ 7.047) per surgery avoided. In the sensitivity analysis the adhesion rate to treatment and the cost of finasteride were the main variables that influenced the results. Conclusions: These findings suggest that the treatment of BPH with finasteride is costeffective compared to placebo in the Brazilian public health system perspective.

show abstract

“…Evidence from systematic reviews indicates that when used in combination, or alone, such pharmaceutical interventions may improve urine flow, nocturia and quality of life (Tacklind et al 2010;Wilt et al 2008). These benefits are offset by adverse events associated with these pharmaceutical interventions including increased rates of erectile dysfunction, decrease in libido, hypotension and dizziness (Tacklind et al 2010;Wilt et al 2008). Surgical intervention via a transurethral resection of the prostate (TURP) is successful in treating BPH and LUTS in 75 % of men, but is also associated with greater morbidity than pharmaceutical intervention including blood loss, infection and erectile dysfunction (Hoffman et al 2000).…”

mentioning

confidence: 99%

Lycopene for the Prevention and Treatment of Prostate Disease

Ilić

2014

Prostate Cancer Prevention

View full text Add to dashboard Cite

Benign prostatic hyperplasia (BPH) and prostate cancer are common diseases of the prostate gland. BPH is commonly treated by pharmaceutical products, which commonly improve symptoms but are often off-set by adverse events including erectile dysfunction, which affect quality of life. Similarly, a variety of treatment options exist for the treatment of prostate cancer. The applicability of these prostate cancer treatments is reliant on stage of disease. Whilst effectiveness of prostate cancer treatments may vary, common adverse effects include erectile dysfunction, incontinence and lower quality of life. Early evidence from systematic reviews has suggested that diet and lifestyle factors may be beneficial in reducing the risk of cancer. Lycopene, a member of the carotenoid family, found commonly in red pigmented fruit and vegetables has been established as having strong antioxidant and pro-oxidant properties. This chapter examines the current evidence on the use of lycopene as a preventive agent for prostate disease.

show abstract

Finasteride for benign prostatic hyperplasia

Cited by 71 publications

References 76 publications

Long-term Consequences of Finasteride vs Placebo in the Prostate Cancer Prevention Trial

Long-term Consequences of Finasteride vs Placebo in the Prostate Cancer Prevention Trial

Cost-effectiveness analysis of medical treatment of benign prostatic hyperplasia in the Brazilian public health system

Lycopene for the Prevention and Treatment of Prostate Disease

Contact Info

Product

Resources

About