Efficacy and tolerability of the dual 5α-reductase inhibitor, dutasteride, in the treatment of benign prostatic hyperplasia in African-American men

Roehrborn, Claus G.; Ray, Paul S.

doi:10.1038/sj.pcan.4500911

Cited by 8 publications

(3 citation statements)

References 33 publications

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“…In addition, LUTS deterioration, AUR, and BPHrelated surgery are all closely associated with the clinical progression of BPH . Several reports have confirmed that the long-term treatment of BPH patients with 5-ARIs, finasteride, and dutasteride can lead to reductions in the risk of developing AUR, and a reduction in the need for BPHrelated surgery (Roehrborn and Ray, 2006;Kaplan et al, 2011). It is particularly evident that 5-ARIs can significantly prevent the progression of BPH.…”

Section: The Efficacy Of 5-aris In the Treatment Of Bphmentioning

confidence: 93%

Efficacy and Side Effects of Drugs Commonly Used for the Treatment of Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia

Yan

et al. 2020

Front. Pharmacol.

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Benign prostatic hyperplasia (BPH) is the most common benign disease of the prostate gland and is caused by benign hyperplasia of the smooth muscle cells and stromal cells in this important gland. BPH is also the most common disease underlying lower urinary tract symptoms (LUTS). The incidence of BPH increases with age and affects more than half of all men 50 years or older. BPH mainly exerts effects on urinary function and can seriously reduce a patient's quality of life. At present, treatment for BPH aims primarily to improve the quality of life and reduce the risk of BPH-related complications. Pharmacological therapy is recommended for moderate-to-severe cases of LUTS that are suggestive of BPH. A range of drugs is currently available to treat this condition, including a1adrenoceptor antagonists, 5a-reductase inhibitors (5-ARIs), phosphodiesterase type 5 inhibitors (PDE5Is), muscarinic receptor antagonists (MRAs), b3-adrenoceptor agonists, and plant extracts. Of these, the most commonly used drugs in the clinic are a1adrenoceptor antagonists, 5-ARIs, and combination therapy. However, these drugs exert their effects via various mechanisms and are associated with adverse reactions. The purpose of this review is to provide current comprehensive perspectives on the mechanisms of action, efficacy, and adverse reactions associated with the drugs most commonly used for the treatment of BPH.

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Section: The Efficacy Of 5-aris In the Treatment Of Bphmentioning

confidence: 93%

Efficacy and Side Effects of Drugs Commonly Used for the Treatment of Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia

Yan

et al. 2020

Front. Pharmacol.

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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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“…Of note, PCa chemopreventive trials did not include enough AAM to conduct separate analyses for that racial group. However, a study [45] concluded that when dutasteride was used for the treatment of benign prostate hyperplasia (BPH), the efficacy and safety profiles were similar in AA and EA men. Hence, although it is conceivable that 5-alpha-reductase inhibitors may be differentially active in AAM due to an overactive AR-mediated pathway, at this time there’s not enough evidence to support this claim.…”

Section: Pca Chemoprevention In Aammentioning

confidence: 99%

Prostate cancer chemoprevention in men of African descent: current state of the art and opportunities for future research

Chornokur

Kumar

2013

Cancer Causes Control

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Prostate cancer is the most frequently diagnosed malignancy in men. However, African American / Black men are 60% more likely to be diagnosed with and 2.4 times more likely to die from prostate cancer, compared to Non-Hispanic White men. Despite the increased burden of this particular malignancy, no evidence-based recommendation regarding prostate cancer screening exists for the high risk population. Moreover, in addition to screening and detection, high-risk African American men may constitute a prime population for chemoprevention. Early detection and chemoprevention may thus represent an integral part of prostate cancer control in this population. Importantly, recent research have elucidated biological differences in the prostate tumors of African American compared to European American men,. The latter may enable a more favorable response in African American men to specific chemopreventive agents that target relevant signal transduction pathways. Based on this evolving evidence, the aims of this review are three-fold. First, we aim to summarize the biological differences that were reported in the prostate tumors of African American and European American men. Second, we will review the single and multi target chemopreventive agents placing specific emphasis on targeting the pathways implicated in prostate carcinogenesis. And lastly, we will discuss the most promising multi-target nutraceutical chemopreventive compounds. Our review underscores the promise of chemoprevention in prostate cancer control, as well as provides justification for further growth and investment in this filed to ultimately reduce prostate cancer morbidity and mortality in this high risk population of African American men.

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Efficacy and tolerability of the dual 5α-reductase inhibitor, dutasteride, in the treatment of benign prostatic hyperplasia in African-American men

Cited by 8 publications

References 33 publications

Efficacy and Side Effects of Drugs Commonly Used for the Treatment of Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia

Efficacy and Side Effects of Drugs Commonly Used for the Treatment of Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia

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

Prostate cancer chemoprevention in men of African descent: current state of the art and opportunities for future research

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