Comparison of Finasteride (Proscar®) and Serenoa repens (Permixon®) in the Inhibition of 5-Alpha Reductase in Healthy Male Volunteers

Strauch, G; Perles, P; Vergult, Gerard; Gabriel, Mordecai; Gibelin, B.; Cummings, Stuart; Malbecq, William; Malice, Marie‐Pierre

doi:10.1159/000475388

Cited by 71 publications

(28 citation statements)

References 13 publications

(16 reference statements)

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“…In fact, serum dihydrotestosterone did not decrease, indicating that the inhibition of 5-␣ reductase is not an important part of the mechanism (table 4). [15][16][17] Since we noted no effect of saw palmetto herbal blend on prostate inflammatory tissues, we did not confirm the antiinflammatory hypothesis of Helpap et al 18 An unexplained finding in our series is the lack of a change in serum PSA despite marked epithelial contraction. This apparent paradox may involve some novel mechanism of action that was not detected in our studies of apoptosis, cell proliferation, growth factors, angiogenesis and androgen receptor expression.…”

Section: Discussioncontrasting

confidence: 80%

Effects of a Saw Palmetto Herbal Blend in Men With Symptomatic Benign Prostatic Hyperplasia

Marks¹,

Partin²,

Epstein³

et al. 2000

The Journal of Urology

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Purpose: We tested the effects of a saw palmetto herbal blend in men with symptomatic benign prostatic hyperplasia (BPH) via a randomized, placebo controlled trial.Materials and Methods: We randomized 44 men 45 to 80 years old with symptomatic BPH into a trial of a saw palmetto herbal blend versus placebo. End points included routine clinical measures (symptom score, uroflowmetry and post-void residual urine volume), blood chemistry studies (prostate specific antigen, sex hormones and multiphasic analysis), prostate volumetrics by magnetic resonance imaging, and prostate biopsy for zonal tissue morphometry and semiquantitative histology studies.Results: Saw palmetto herbal blend and placebo groups had improved clinical parameters with a slight advantage in the saw palmetto group (not statistically significant). Neither prostate specific antigen nor prostate volume changed from baseline. Prostate epithelial contraction was noted, especially in the transition zone, where percent epithelium decreased from 17.8% at baseline to 10.7% after 6 months of saw palmetto herbal blend (p Ͻ0.01). Histological studies showed that the percent of atrophic glands increased from 25.2% to 40.9% after treatment with saw palmetto herbal blend (p Ͻ0.01). The mechanism of action appeared to be nonhormonal but it was not identified by tissue studies of apoptosis, cellular proliferation, angiogenesis, growth factors or androgen receptor expression. We noted no adverse effects of saw palmetto herbal blend. When the study was no longer blinded, 41 men elected to continue therapy in an open label extension.Conclusions: Saw palmetto herbal blend appears to be a safe, highly desirable option for men with moderately symptomatic BPH. The secondary outcome measures of clinical effect in our study were only slightly better for saw palmetto herbal blend than placebo (not statistically significant). However, saw palmetto herbal blend therapy was associated with epithelial contraction, especially in the transition zone (p Ͻ0.01), indicating a possible mechanism of action underlying the clinical significance detected in other studies.

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Section: Discussioncontrasting

confidence: 80%

Effects of a Saw Palmetto Herbal Blend in Men With Symptomatic Benign Prostatic Hyperplasia

Marks¹,

Partin²,

Epstein³

et al. 2000

The Journal of Urology

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“…The greatest efficacy is achieved by a combination ofmedical treatment and hair transplant surgery (1,(6)(7)(8)(9).…”

mentioning

confidence: 99%

Comparitive Effectiveness and Finasteride Vs Serenoa Repens in Male Androgenetic Alopecia: A Two-Year Study

Rossi

Mari

Scarnò³

et al. 2012

Int J Immunopathol Pharmacol

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The objective of this open label study is to determine the effectiveness of Serenoa repens in treating male androgenetic alopecia (AGA), by comparing its results with finasteride. For this purpose, we enrolled 100 male patients with clinically diagnosed mild to moderate AGA. One group received Serenoa repens 320 mg every day for 24 months, while the other received finasteride 1 mg every day for the same period. In order to assess the efficacy of the treatments, a score index based on the comparison of the global photos taken at the beginning (TO) and at the end (T24) of the treatment, was used. The results showed that only 38% of patients treated with Serenoa repens had an increase in hair growth, while 68% of those treated with finasteride noted an improvement. Moreover finasteride was more effective for more than half of the patients (33 of 50, i.e, 66%), with level II and III alopecia. We can summarize our results by observing that Serenoa repens could lead to an improvement of androgenetic alopecia, while finasteride confirmed its efficacy. We also clinically observed, that finasteride acts in both the front area and the vertex, while Serenoa repens prevalently in the vertex. Obviously other studies will be necessary to clarify the mechanisms that cause the different responses of these two treatments.Androgenetic alopecia (AGA) is a common form of scalp hair loss that affects up to 80% of elderly males (mostly over 60 years old). The onset ofAGA is extremely variable and the physical aspect is characterized by progressive miniaturization of scalp hair follicles (1, 2). Even though this condition is not considered a serious pathology, it is well known that loss of hair leads to stressful events for patients, often with considerable psychosocial consequences. Genetic factors and androgens playa major role in the pathogenesis of the disease. Polymorphism of the androgen receptor genes was first identified in association with androgenetic alopecia. These facts lead to different kinds of AGA patterns that often occur in members of the same families.Anamnesis and clinical examination can lead to the correct diagnosis of AGA, as well as a dermoscopy that can evidence the beginning of the miniaturization of the scalp hair follicles. The presence of more than 20% vellus-like hair in the androgen dependent areas can also lead to diagnosis of initial AGA (3-6).Minoxidil and finasteride are commonly used in treating AGA, both of which have FDA approval; dutasteride, a type I and II 5-alpha-reductase inhibitor, should also be considered and is currently in Phase

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“…In a study of castrated rats treated with testosterone or dihydrotestosterone, finasteride, but not permixon, was found to inhibit prostate growth [25]. Similarly, a decrease in serum dihydrotestosterone was noted only in men who were treated with finasteride, compared with other healthy volunteers who received permixon or placebo [26]. In contrast, a statistically significant reduction in dihydrotestosterone was found in men treated with permixon compared with control subjects during a 3-month treatment period [27].…”

Section: Saw Palmettomentioning

confidence: 96%

Saw palmetto and finasteride in the treatment of category-iii prostatitis/chronic pelvic pain syndrome

Yang

2005

Curr Urol Rep

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Chronic nonbacterial prostatitis/chronic pelvic pain syndrome is a common entity for which a standardized management has not been established. Patients often have a significant symptom complex and impact on quality of life, but very little is known about the efficacy of second- and third-line treatments, such as the use of herbal supplements. Many treatments studied in recent literature include antibiotics, alpha-blockade, anti-inflammatory agents, and cognitive behavioral interventions such as biofeedback and psychotherapy.

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Comparison of Finasteride (Proscar®) and Serenoa repens (Permixon®) in the Inhibition of 5-Alpha Reductase in Healthy Male Volunteers

Cited by 71 publications

References 13 publications

Effects of a Saw Palmetto Herbal Blend in Men With Symptomatic Benign Prostatic Hyperplasia

Effects of a Saw Palmetto Herbal Blend in Men With Symptomatic Benign Prostatic Hyperplasia

Comparitive Effectiveness and Finasteride Vs Serenoa Repens in Male Androgenetic Alopecia: A Two-Year Study

Saw palmetto and finasteride in the treatment of category-iii prostatitis/chronic pelvic pain syndrome

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