Efficacy and safety of a fixed‐dose combination of dutasteride and tamsulosin treatment (<scp>D</scp>uodart<sup>®</sup>) compared with watchful waiting with initiation of tamsulosin therapy if symptoms do not improve, both provided with lifestyle advice, in the management of treatment‐naïve men with moderately symptomatic benign prostatic hyperplasia: 2‐year <scp>CONDUCT</scp> study results

Roehrborn, Claus G.; Perez, Igor Oyarzabal; Roos, Erik; Calomfirescu, N.; Brotherton, Betsy; Wang, Fang; Palacios, J.M.; Vasylyev, Averyan; Manyak, Michael J.

doi:10.1111/bju.13033

Cited by 81 publications

(68 citation statements)

References 32 publications

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“…An editorial following the report by Belknap [89] has highlighted the need to re-think the safety of these drugs [90]. The following section summarizes preclinical and clinical evidence documenting how finasteride and dutasteride may impair sexual function, including sexual desire, erectile, ejaculation and orgasmic function [23,[91][92][93][94][95].…”

Section: Adverse Effects On Sexual Functionmentioning

confidence: 99%

Adverse effects of 5α-reductase inhibitors: What do we know, don’t know, and need to know?

Traish

Melcangi

Bortolato

et al. 2015

Rev Endocr Metab Disord

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Steroids are important physiological orchestrators of endocrine as well as peripheral and central nervous system functions. One of the key processes for regulation of these molecules lies in their enzymatic processing by a family of 5α-reductase (5α-Rs) isozymes. By catalyzing a key rate-limiting step in steroidogenesis, this family of enzymes exerts a crucial role not only in the physiological control but also in pathological events. Indeed, both 5α-R inhibition and supplementation of 5α-reduced metabolites are currently used or have been proposed as therapeutic strategies for a wide array of pathological conditions. In particular, the potent 5α-R inhibitors finasteride and dutasteride are used in the treatments of benign prostatic hyperplasia (BPH), as well as in male pattern hair loss (MPHL) known as androgenetic alopecia (AGA). Recent preclinical and clinical findings indicate that 5α-R inhibitors evoke not only beneficial, but also adverse effects. Future studies should investigate the biochemical and physiological mechanisms that underlie the persistence of the adverse sexual side effects to determine why a subset of patients is afflicted with such persistence or irreversible adverse effects. Also a better focus of clinical research is urgently needed to better define those subjects who are likely to be adversely affected by such agents. Furthermore, research on the non-sexual adverse effects such as diabetes, psychosis, depression, and cognitive function are needed to better understand the broad spectrum of the effects these drugs may elicit during their use in treatment of AGA or BPH. In this review, we will summarize the state of art on this topic, overview the key unresolved questions that have emerged on the pharmacological targeting of these enzymes and their products, and highlight the need for further studies to ascertain the severity and duration of the adverse effects of 5α-R inhibitors, as well as their biological underpinnings.

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Section: Adverse Effects On Sexual Functionmentioning

confidence: 99%

Adverse effects of 5α-reductase inhibitors: What do we know, don’t know, and need to know?

Traish

Melcangi

Bortolato

et al. 2015

Rev Endocr Metab Disord

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“…5α-Reductase inhibitors (5α-RIs) therapy with finasteride or dutasteride and α 1 -adrenergic receptor blockers such as tamsulosin are widely used for treatment of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) [1,2]. 5α-RIs therapy with finasteride is also widely used for treatment of male pattern hair loss (MPHL), commonly known as androgenetic alopecia (AGA) [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…5α-RIs therapy with finasteride is also widely used for treatment of male pattern hair loss (MPHL), commonly known as androgenetic alopecia (AGA) [3,4]. However, one of the main concerns with 5α-RIs therapy is the serious adverse effects on sexual function [1,[5][6][7][8][9][10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

“…Many investigators believe that the adverse effects on sexual function affects only a small proportion of treated patients and such adverse effects are thought to resolve with continuing treatment [1,. Unfortunately, this notion is inaccurate and a significant number of patients complain of erectile dysfunction (ED) which does not resolve with continued treatment as claimed previously [6-15, 33, 36].…”

Section: Introductionmentioning

confidence: 99%

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Finasteride, not tamsulosin, increases severity of erectile dysfunction and decreases testosterone levels in men with benign prostatic hyperplasia

Traish

Haider²,

Doros

et al. 2015

Hormone Molecular Biology and Clinical Investigation

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“…A multicenter, randomized, non-blinded study, that included treatment-naive patients with moderately symptomatic BPH, concluded that a fixed dose of dutasteride/tamsulosin may reduce the risk of clinical progression and improve symptoms compared to expectant treatment, with optional tamsulosin prescription (initiation of protocol-defined therapy if symptoms did not improve). 20 (A)…”

Section: (A)mentioning

confidence: 99%