Long‐term sustained improvement in symptoms of benign prostatic hyperplasia with the dual 5α‐reductase inhibitor dutasteride: results of 4‐year studies

Abstract

included a breakdown of the AUA-SI score, including stratifying patients by symptom severity, assessment by baseline age and prostate volume, and the evaluation of symptoms responders. RESULTSThere was a clinically meaningful improvement in AUA-SI in patients on dutasteride in the double-blind phase, but not in those on placebo. At 48 months, patients on dutasteride in both study phases had greater improvements in AUA-SI score and individual question scores than those on dutasteride in the open-label phase only. The proportion of patients with severe symptoms declined in both study groups, although these changes were more profound in those receiving dutasteride for the 4-year duration of the study. CONCLUSIONIn men with symptomatic benign prostatic hyperplasia, long-term (4-year) treatment with the dual isozyme 5 a -reductase inhibitor dutasteride resulted in sustained and continued improvements in symptoms and flow rate. For 4 vs 2 years, longer dutasteride therapy resulted in greater symptom improvement.

Dutasteride significantly improves quality of life measures in patients with enlarged prostate

“…In addition, each question from the AUA-SI positively correlated with the matching question from the SPI (Po0.0001). Dutasteride treatment resulted in significant improvement in all seven questions of both the AUA-SI 15 and SPI, including the nocturia scores. Although the overall numerical improvement was lower for nocturia than for the other questions, a treatment impact on this end point is important because the etiology of nocturia is often quite variable, and the effect of drug treatment is not well defined.…”

Alpha-Blockers and Intraoperative Floppy Iris Syndrome: Ophthalmic Adverse Events Following Cataract Surgery

“…Activation of these receptors and the subsequent increase in prostatic smooth muscle tone with urethral constriction and impaired flow of urine have been proposed as contributors to the pathophysiology of symptomatic bladder outlet obstruction from BPH. In addition, there is evidence that adrenergic receptors further mediate the symptoms of BPH via their activation within the central nervous system and bladder [7,8].…”

Dutasteride affects progesterone metabolizing enzyme activity/expression in human breast cell lines resulting in suppression of cell proliferation and detachment

“…[4][5][6][7][8][9][10][11][12][13][14] C]4-pregnen-20␣-ol-3-one (20␣HP; 50.8 mCi/mmol) was derived from the [ 14 C]progesterone metabolism studies of dutasteride treated MCF-10A cells. Unlabeled 3␣HP was synthesized as described [19].…”

“…Dutasteride is an inhibitor of both 5␣-reductase types 1 and 2 [6] that has been employed in several trials to inhibit the 5␣-reduction of testosterone to 5␣-dihydrotestosterone (DHT) in men with benign prostate hyperplasia [7][8][9][10] and prostate cancer [11][12][13][14]. Treatment with dutasteride results in >90% reduction in circulating [7,9] and intraprostatic [11] DHT, leading to reduced prostate size [10], altered gene expression [15], increased apoptosis [13,16] and potential chemoprevention of prostate cancer [14]. The aims of the current studies were to determine the effect of dutasteride on (a) progesterone conversion to 5␣-pregnanes and 4-pregnenes, (b) 5␣-reductase and HSO activities and mRNA expression and (c) proliferation and detachment of MCF-7 and MCF-10A breast cell lines.…”