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Duijnhoven RG, Straus SMJM, Souverein PC, de Boer A, Bosch JLHR, Hoes AW, De Bruin ML. Long-term use of 5α-reductase inhibitors and the risk of male breast cancer. Cancer Causes Control 2014; 25:1577-82. [PMID: 25135615 DOI: 10.1007/s10552-014-0455-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 07/31/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND The 5α-reductase inhibitors (5-ARI) finasteride and dutasteride are indicated for the treatment of lower urinary tract symptoms caused by benign prostatic hyperplasia. Case reports have suggested that 5-ARIs increase the risk for male breast cancer, with no conclusive evidence. The objective of this study was to quantify the association between use of 5-ARIs and the risk for male breast cancer. METHODS A case-control study was conducted with data from the United Kingdom Clinical Practice Research Datalink database among all men aged 45 years and older in the period 1 January 1992 to 31 December 2011. Cases of men diagnosed with breast cancer were matched to up 10 controls on age and general practice. Crude and adjusted odds ratios were estimated for the risk of breast cancer associated with the use of 5-ARIs. RESULTS Three hundred and ninety-eight cases were identified and matched to 3,930 controls. Ever use of 5-ARIs was associated with an adjusted odds ratio for breast cancer of 1.08 (95 % CI 0.62-1.87) compared to non-users. Increasing cumulative duration of treatment showed no increasing risks: adjusted odds ratios for use for less than 280, for 280 to 1,036 and for more than 1,036 days were 1.21 (95 % CI 0.47-3.10), 0.94 (95 % CI 0.36-2.41) and 1.29 (95 % CI 0.54-3.08), respectively. CONCLUSIONS In this study, there was no evidence of an association between short- or long-term treatment with 5-ARIs and the risk for breast cancer in older men.
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Affiliation(s)
- Ruben G Duijnhoven
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG, Utrecht, The Netherlands,
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Abstract
BACKGROUND Androgenetic alopecia (AGA) is one of the most common chronic problems seen by dermatologists worldwide. It is characterized by progressive hair loss, especially of scalp hair, and has distinctive patterns of loss in women versus men, but in both genders the central scalp is most severely affected. It often begins around puberty and is known to effect self-esteem and the individual's quality of life. In contrast to the high prevalence of AGA, approved therapeutic options are limited. In addition to the scarce pharmacologic treatments, there are numerous nonprescription products claimed to be effective in restoring hair in androgenetic alopecia. OBJECTIVES The purpose of this paper is to review published medical and non-medical treatments for male and female AGA using the American College of Physicians evidence assessment methods. MEDLINE, EMBASE and Cochrane Library were searched for systematic reviews, randomized controlled trials, open studies, case reports and relevant studies of the treatment of male and female AGA. The relevant articles were classified according to grade and level of evidence. RESULTS The medical treatments with the best level of evidence classification for efficacy and safety for male AGA are oral finasteride and topical minoxidil solution. For female AGA, topical minoxidil solution appears to be the most effective and safe treatment. The medical treatments corresponding to the next level of evidence quality are some commonly used therapeutic non-FDA-approved options including oral and topical anti-hormonal treatments. Surgical treatment of follicular unit hair transplantation is an option in cases that have failed medical treatment although there is high variation in outcomes. LIMITATIONS Some articles, especially those concerning traditional herbs claimed to promote hair regrowth, were published in non-English, local journals. CONCLUSIONS An assessment of the evidence quality of current publications indicates that oral finasteride (for men only) and topical minoxidil (for men and women) are the best treatments of AGA.
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Affiliation(s)
- Supenya Varothai
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Di Loreto C, La Marra F, Mazzon G, Belgrano E, Trombetta C, Cauci S. Immunohistochemical evaluation of androgen receptor and nerve structure density in human prepuce from patients with persistent sexual side effects after finasteride use for androgenetic alopecia. PLoS One 2014; 9:e100237. [PMID: 24959691 PMCID: PMC4069023 DOI: 10.1371/journal.pone.0100237] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 05/24/2014] [Indexed: 11/25/2022] Open
Abstract
Finasteride is an inhibitor of 5-α-reductase used against male androgenetic alopecia (AGA). Reported side effects of finasteride comprise sexual dysfunction including erectile dysfunction, male infertility, and loss of libido. Recently these effects were described as persistent in some subjects. Molecular events inducing persistent adverse sexual symptoms are unexplored. This study was designed as a retrospective case-control study to assess if androgen receptor (AR) and nerve density in foreskin prepuce specimens were associated with persistent sexual side effects including loss of sensitivity in the genital area due to former finasteride use against AGA. Cases were 8 males (aged 29–43 years) reporting sexual side effects including loss of penis sensitivity over 6 months after discontinuation of finasteride who were interviewed and clinically visited. After informed consent they were invited to undergo a small excision of skin from prepuce. Controls were 11 otherwise healthy matched men (aged 23–49 years) who undergone circumcision for phimosis, and who never took finasteride or analogues. Differences in AR expression and nerve density in different portions of dermal prepuce were evaluated in the 2 groups. Density of nuclear AR in stromal and epithelial cells was higher in cases (mean 40.0%, and 80.6% of positive cells, respectively) than controls (mean 23.4%, and 65.0% of positive cells, respectively), P = 0.023 and P = 0.043, respectively. Conversely, percentage of vessel smooth muscle cells positive for AR and density of nerves were similar in the 2 groups. The ratio of AR positive stromal cells % to serum testosterone concentrations was 2-fold higher in cases than in controls (P = 0.001). Our findings revealed that modulation of local AR levels might be implicated in long-term side effects of finasteride use. This provides the first evidence of a molecular objective difference between patients with long-term adverse sexual effects after finasteride use versus drug untreated healthy controls in certain tissues.
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Affiliation(s)
- Carla Di Loreto
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Udine, Italy
| | - Francesco La Marra
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Udine, Italy
| | - Giorgio Mazzon
- Urological Hospital Department, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Emanuele Belgrano
- Urological Hospital Department, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Carlo Trombetta
- Urological Hospital Department, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Sabina Cauci
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Udine, Italy
- * E-mail:
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Osman N, Chapple CR. Contemporary issues with pharmacotherapy for lower urinary tract symptoms. Int J Clin Pract 2014; 68:541-2. [PMID: 24750526 DOI: 10.1111/ijcp.12302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Two articles appeared in the November 2012 edition of the journal evaluating aspects relating to the use of two important pharmacotherapeutic classes for lower urinary tract symptoms (LUTS) in real life clinical practice. LUTS is a non-specific term that encompasses urine storage, voiding and postmicturition symptoms. LUTS is a common bothersome problem affecting both men and women with a comparable prevalence in age-matched patients of both sexes that increases with ageing.
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Affiliation(s)
- N Osman
- The Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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Famenini S, Gharavi NM, Beynet DP. Finasteride associated melasma in a Caucasian male. J Drugs Dermatol 2014; 13:484-486. [PMID: 24719069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Melasma is an acquired hypermelanosis that typically affects sun-exposed areas on the face and presents as symmetric brownish macules and patches. It is most commonly reported in women and thought to be related to the effects of estrogen and progesterone on melanocytes. Since the advent of finasteride 1mg daily tablets for the treatment of androgenic alopecia, we have noticed an increase in the number of men presenting with melasma. Here we present one of those cases. We hypothesize this could be related to the effects of finasteride on estrogen and progesterone concentrations in the skin.
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Gomella LG. Actos, slings, finasteride, and the vaccine compensation solution. Can J Urol 2013; 20:6668. [PMID: 23587504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Kormos W. On call. I have read several news reports that claim finasteride, which I take for my prostate problem, can cause permanent impotence. Should I be concerned? Harv Mens Health Watch 2013; 17:2. [PMID: 23807950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Ricci G, Martinelli M, Luppi S, Lo Bello L, De Santis M, Skerk K, Zito G. Finasteride and fertility: case report and review of the literature. J Drugs Dermatol 2012; 11:1511-1513. [PMID: 23377525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Although millions of men have taken or are taking finasteride, there are no documented cases of successful pregnancy in the literature after discontinuation of the drug. Early studies did not show significant influence of finasteride on semen parameters, whereas some recent observations have suggested that in subfertile patients, the effects of the drug might be amplified. Therefore, counseling is particularly difficult for men taking finasteride and planning pregnancy. We report the case of a couple whose male partner had used finasteride for approximately 10 years and who presented for primary infertility. The first semen analysis, carried out 3 months after finasteride cessation, revealed severe oligospermia. One month later, sperm concentration increased, and the following month, the couple spontaneously conceived. A healthy baby was delivered at full term. To the best of our knowledge, this is the first case of successful full-term pregnancy and live birth after long-term use of finasteride, which suggests that treatment with finasteride, even after several years, does not prevent normal conception. However, caution should be advised with the use of finasteride in male partners of couples who are attempting to become pregnant.
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Affiliation(s)
- Giuseppe Ricci
- Assisted Reproduction Unit, Institute for Maternal and Child Health, IRCCS Burlo Garofalo, Trieste, Italy.
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Corona G, Rastrelli G, Maseroli E, Balercia G, Sforza A, Forti G, Mannucci E, Maggi M. Inhibitors of 5α-reductase-related side effects in patients seeking medical care for sexual dysfunction. J Endocrinol Invest 2012; 35:915-20. [PMID: 22777612 DOI: 10.3275/8510] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Despite their efficacy in the treatment of benign prostatic hyperplasia (BPH) the popularity of inhibitors of 5α-reductase (5ARI) is limited by their association with adverse sexual side effects. However, the real impact of 5ARI on sex hormones and sexual function is controversial. AIM To investigate the role of 5ARI therapy on hormonal parameters and sexual function in men already complaining of sexual problems. MATERIALS AND METHODS A consecutive series of 3837 men (mean age 63.5±12.8 yr) attending our outpatient clinic for sexual dysfunction was retrospectively studied. Several clinical, biochemical, and instrumental (penile color doppler ultrasound) factors were evaluated. RESULTS Among the patients studied, 78.7% reported erectile dysfunction, 51.1% hypoactive sexual desire (HSD), 86.7% perceived reduced sleep-related erections (PR-SRE) and 19.1% premature ejaculation. The use of 5ARI was associated with an increased risk of HSD and PR-SR whereas no relationship was found with erectile dysfunction and ejaculation disturbances. Subjects using 5ARI also more frequently had gynecomastia along with reduced SHBG and higher calculated free testosterone levels. All these associations were confirmed in a case-control study comparing 5ARI users with age-body mass index-smoking status and total testosterone-matched controls. CONCLUSIONS Our data indicates that use of 5ARI in men with sexual dysfunction does not significantly exacerbate pre-existing ejaculatory or erectile difficulties, but can further impair their sexual life by reducing sexual drive and spontaneous erection.
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Affiliation(s)
- G Corona
- Sexual Medicine and Andrology Unit, Department of Clinical Physiopathology, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
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Abstract
When prostate-specific antigen (PSA) testing was introduced, proponents expected it to cut prostate-cancer mortality and did not expect it to unleash an epidemic of unnecessary treatments. Now that evidence of a mortality benefit remains unclear while evidence of overtreatment in undeniable, there is understandable interest in reducing the human costs of the PSA system. Two related drugs, finasteride and dutasteride, both proven to reduce the incidence of prostate cancer and the "risk of diagnosis," are being promoted accordingly. However, if not for the flaws of the PSA system the use of these drugs for purposes of prevention would lose its rationale. Not only are the drugs in this sense dependent on a faulty system, but their own mortality benefits are as speculative as PSA's-in addition to which, they introduce new risks.
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Affiliation(s)
- Marc R Theoret
- Office of Oncology Drug Products, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
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Bergstrom KG. What's new in androgenetic alopecia: approvals, long-term safety data, cancer risk and treatment options for women. J Drugs Dermatol 2011; 10:98-101. [PMID: 22303550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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66
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Finasteride: male breast cancer. Prescrire Int 2010; 19:283. [PMID: 21355383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Abstract
BACKGROUND Benign prostatic hyperplasia (BPH), a non-malignant enlargement of the prostate in aging men, can cause bothersome urinary symptoms (intermittency, weak stream, straining, urgency, frequency, incomplete emptying). Finasteride, a five-alpha reductase inhibitor (5ARI), blocks the conversion of testosterone to dihydrotestosterone, reduces prostate size, and is commonly used to treat symptoms associated with BPH. OBJECTIVES To compare the clinical effectiveness and harms of finasteride versus placebo and active controls in the treatment of lower urinary tract symptoms (LUTS). SEARCH STRATEGY We searched The Cochrane Library (which includes CDSR (Cochrane Database of Systematic Reviews), DARE (Database of Abstracts of Reviews of Effects), HTA (Heath Technology Assessments), and CENTRAL (Cochrane Central Register of Controlled Trials, and which includes EMBASE and MEDLINE), LILACS (Latin American and Caribbean Center on Health Sciences Information) and Google Scholar for randomized, controlled trials (RCTs). We also handsearched systematic reviews, references, and clinical-practice guidelines. SELECTION CRITERIA Randomized trials in the English language with placebo and/or active arms with a duration of at least 6 months. DATA COLLECTION AND ANALYSIS JT extracted the data, which included patient characteristics, outcomes, and harms. Our primary outcome was change in a validated, urinary symptom-scale score, such as the AUA/IPSS. A clinically meaningful change was defined as 4 points. We also categorized outcomes by trial lengths of ≤ 1 year (short term) and > 1 year (long term). MAIN RESULTS Finasteride consistently improved urinary symptom scores more than placebo in trials of > 1 year duration, and significantly lowered the risk of BPH progression (acute urinary retention, risk of surgical intervention, ≥ 4 point increase in the AUASI/IPSS). In comparison to alpha-blocker monotherapy, finasteride was less effective than either doxazosin or terazosin, but equally effective compared to tamsulosin. Both doxazosin and terazosin were significantly more likely than finasteride to improve peak urine flow and nocturia, versus finasteride. Versus tamsulosin, peak urine flow and QoL improved equally well versus finasteride. However, finasteride was associated with a lower risk of surgical intervention compared to doxazosin, but not to terazosin, while finasteride and doxazosin were no different for risk of acute urinary retention. Two small trials reported no difference in urinary symptom scores between finasteride and tamsulosin. Finasteride + doxazosin and doxazosin monotherapy improved urinary symptoms equally well (≥ 4 point improvement).For finasteride, there was an increased risk of ejaculation disorder, impotence, and lowered libido, versus placebo. Versus doxazosin, finasteride had a lower risk of asthenia, dizziness, and postural hypotension, and versus terazosin, finasteride had a significant, lower risk of asthenia, dizziness, and postural hypotension. AUTHORS' CONCLUSIONS Finasteride improves long-term urinary symptoms versus placebo, but is less effective than doxazosin. Long-term combination therapy with alpha blockers (doxazosin, terazosin) improves symptoms significantly better than finasteride monotherapy. Finasteride + doxazosin improves symptoms equally - and clinically - to doxazosin alone. In comparison to doxazosin, finasteride + doxazosin appears to improve urinary symptoms only in men with medium (25 to < 40 mL) or large prostates (≥ 40 mL), but not in men with small prostates (25 mL).Comparing short to long-term therapy, finasteride does not improve symptoms significantly better than placebo at the short term, but in the long term it does, although the magnitude of differences was very small (from < 1.0 point to 2.2 points). Doxazosin improves symptoms better than finasteride both short and long term, with the magnitude of differences ∼2.0 points and 1.0 point, respectively. Finasteride + doxazosin improves scores versus finasteride alone at both short and long term, with mean differences ∼2.0 points for both time points. Finasteride + doxazosin versus doxazosin improves scores equally for short and long term.Drug-related adverse effects for finasteride are rare; nevertheless, men taking finasteride are at increased risk for impotence, erectile dysfunction, decreased libido, and ejaculation disorder, versus placebo. Versus doxazosin, which has higher rates of dizziness, postural hypotension, and asthenia, men taking finasteride are at increased risk for impotence, erectile dysfunction, decreased libido, and ejaculation disorder. Finasteride significantly reduces asthenia, postural hypotension, and dizziness versus terazosin. Finasteride significantly lowers the risk of asthenia, dizziness, ejaculation disorder, and postural hypotension, versus finasteride + terazosin.
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Affiliation(s)
| | - Howard A Fink
- Minneapolis VA Medical CenterGeriatric Research Education and Clinical Center, Box 11GOne Veterans DriveMinneapolisMinnesotaUSA55417
| | - Roderick MacDonald
- Minneapolis VA Medical CenterGeneral Internal Medicine (111‐0)One Veterans DriveMinneapolisMinnesotaUSA55417
| | - Indy Rutks
- Minneapolis VA Medical CenterGeneral Internal Medicine (111‐0)One Veterans DriveMinneapolisMinnesotaUSA55417
| | - Timothy J Wilt
- Minneapolis VA Medical CenterGeneral Internal Medicine (111‐0)One Veterans DriveMinneapolisMinnesotaUSA55417
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Lochner S. [Interactions between St John's wort extract and finasteride?]. Med Monatsschr Pharm 2010; 33:307. [PMID: 21189651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Sophie Lochner
- Institut für Klinische Pharmakologie, Medizinische Fakultät, TU Dresden.
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Keller DL. Risks related to the use of finasteride (propecia) in pregnant women. Am Fam Physician 2010; 82:102; author reply 102. [PMID: 20642261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Na HR, Lee JW, Park SM, Ko SB, Kim S, Cho ST. Inappropriate sexual behaviors in patients with vascular dementia: possible response to finasteride. J Am Geriatr Soc 2010; 57:2161-2. [PMID: 20121967 DOI: 10.1111/j.1532-5415.2009.02536.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Leahy Y. Prostate cancer chemoprevention: what is the role of oncology nurses? Can Oncol Nurs J 2010; 20:52-55. [PMID: 20369646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
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Tkachuk VN, Al'-Shukri SK, Tkachuk IN, Mosoian MS. [Efficacy and safety of combined treatment of prostatic adenoma with 5-alpha reductase and alpha-adrenoblockers]. Urologiia 2009:25-27. [PMID: 20169718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Pharmacotherapy of prostatic adenoma is based in present-day practice primarily on two basic groups of medicines--inhibitors of 5alpha-reductase and blockers of alphal-adrenoreceptors. Our trial included 98 patients with prostatic adenoma aged 59-79 years given combined treatment with finasteride (inhibitor of 5alpha-reductase) made in Hungary (prosteride, Gedeon Richter) and an uroselective blocker of alpha1-adrenoreceptors sonisin (Gedeon Richter, Hungary). Prosteride was given for 12 months, sonisine--for the first 6 months of combined treatment. Positive results were achieved in 97 (99%) of 98 patients. After 12-month combined treatment symptoms of the disease reduced by IPSS from 17.9 +/- 1.8 to 3.9 +/- 0.9 points, Qmax rose from 8.8 +/- 0.3 to 14.6 +/- 0.3, residual urine volume diminished from 91.7 +/- 8.5 to 31.7 +/- 4.4, the size of the prostate reduced from 72.4 +/- 2.9 to 50.6 +/- 3.7, quality of life improved 2-fold. Combined administration of finasteride (prosteride) and alpha1-adrenoblocker tamsulosine (sonisine) meet three principles of pharmacotherapy of prostatic adenoma: prevents progression of the disease and surgical treatment, relieves symptoms and improves quality of life.
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Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a distressing condition for which no satisfactory treatment is available. Studies on hormonal mechanisms responsible for HS point towards altered end-organ sensitivity, probably related to the enzyme 5a reductase that converts testosterone to dihydrotestosterone. Finasteride, an inhibitor of type II 5a reductase, has been reported to be effective in recalcitrant HS. AIM To study the effectiveness and tolerability of finasteride in patients with HS in a preliminary trial. METHODS Seven patients (five women and two men) with HS that was not responding well to antibiotics were treated with finasteride at a dose of 5 mg/day as monotherapy. Clinical response was assessed at regular intervals. Patients were followed up for periods varying from 8 months to 2 years. RESULTS Six patients improved significantly and three of them had complete healing of lesions. Two patients who were followed up for more than 1 year experienced remissions lasting 8-18 months. The drug was generally well tolerated; however, two women complained of breast enlargement. CONCLUSION The results of this preliminary study suggest that finasteride is an effective therapeutic option in HS.
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Affiliation(s)
- M A Joseph
- Department of Dermatology, St. John's Medical College Hospital, Bangalore, India.
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75
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Finasteride to prevent prostate cancer: a new chapter. Harv Mens Health Watch 2009; 13:1-4. [PMID: 19579321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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O'Leary M. By the way, doctor. Finasteride has been prescribed for my BPH. I think that the most frequent side effect is erectile dysfunction or loss of sexual desire. Would Levita or a similar drug (like Viagra or Cialis) overcome the side effects of finasteride? Harv Health Lett 2009; 34:8. [PMID: 19623735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Simon HB. On call. I am 76 years old, and I've had an enlarged prostate for at least 10 years. I've been taking Proscar for about a year, and it seems to be helping quite a bit. I have not noticed any side effects, but I'm worried that if the medicine reduces testosterone levels enough to shrink my prostate, it will also give me osteoporosis. Should I change medications, or take Fosamax like my wife? Harv Mens Health Watch 2009; 13:8. [PMID: 19434938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Bollu M, Marte-Grau AC, Bobba RK. 5-Alpha reductase inhibitors and risk of hip fracture. JAMA 2009; 301:935; author reply 935. [PMID: 19258583 DOI: 10.1001/jama.2009.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Dusková M, Hill M, Hanus M, Matousková M, Stárka L. Finasteride treatment and neuroactive steroid formation. Prague Med Rep 2009; 110:222-230. [PMID: 19655698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Finasteride is the 5alpha-reductase inhibitor that received clinical approval for the treatment of human benign prostate hyperplasia and androgenetic alopecia. The 5alpha-reductase is enzyme responsible for the reduction of testosterone to dihydrostestosterone, progesterone to dihydroprogesterone and deoxycorticosterone to dihydrodeoxycorticosterone, steroids modulating the action of gamma-aminobutyric acid on GABA receptors. These neuroactive steroids possess anticonvulsant, antidepressant and anxiolytic effects. The objective of the study was to determine the effect of finasteride therapy on a broad steroid spectrum in men with benign prostate hyperplasia. A group of 20 men with benign prostate hyperplasia was involved in the present study. Finasteride in the daily dose of 5 mg/day was administrated for 4 months. In all individuals, their hormonal profile of steroid hormones was determined before and after 4 months lasting finasteride treatment. Finasteride treatment resulted in a significant decrease all alpha-reduced and increase of most 5beta-reduced metabolites of testosterone and progesterone as well as in an increase of 7alpha-hydoxyderivatives, which are known as neuroactive steroids acting by modulation of GABAA and NMAD receptors in the brain. In the course of finasteride treatment the decrease of the concentration of circulating steroids with known inhibitory activity on GABA-ergic excitation in the brain is very probably an important factors contributing to the development of the symptoms of depression seen in some isolated cases of finasteride administration.
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Affiliation(s)
- M Dusková
- Institute of Endocrinology, Prague, Czech Republic
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Bogdanov AB, Luk'ianov IV, Veliev EI. [Efficacy and safety of doxazosine in combination with finasteride in the treatment of prostatic adenoma]. Urologiia 2008:44-49. [PMID: 19248599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Clinical effects and safety of doxazosine + finasteride combination were studied in patients with obstructive and irritative symptoms due to prostatic adenoma (PA). Lower urinary tract symptoms according to IPSS, size of the prostatic gland, Qmax and Qmid, bladder capacity, residual urine volume, blood pressure, PSA level, sexual function, side effects were assessed before and after combined use of the drugs in 30 patients aged 58 to 83 years (mean age 70.5 years). A significant regression of both obstructive and irritative symptoms by IPSS occurred after the treatment. Quality of life has improved. Combined treatment of PA patients has improved quality of life, urination parameters, reduced volume of residual urine. Good tolerance of the treatment was observed. Combined therapy with doxazosine and finasteride can be recommended as a basic scheme of treatment for patients with risk of PA progression.
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82
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Abstract
CONTEXT For more than 15 years, 5-alpha reductase inhibitors, which block the conversion of testosterone to dihydrotestosterone, have been used in the treatment of benign prostatic hyperplasia (BPH). Short-term studies show no effects of these agents on bone metabolism,but long-term data are not available. OBJECTIVE To assess the association between use of 5-alpha reductase inhibitors (eg, finasteride) for BPH and occurrence of hip fracture. DESIGN, SETTING, AND PATIENTS Population-based case-control study using data from Kaiser Permanente Southern California, a managed care organization with more than 3 million members. Case patients included 7076 men 45 years and older with incident hip fracture from 1997-2006. Control patients were 7076 men without incident hip fracture, optimally matched at a 1:1 ratio to case patients on age and medical center. Electronic information on pharmaceutical use was used to identify use of finasteride from 1991 forward. RESULTS Overall, 2547 (36%) and 2488 (35%) case and control patients, respectively, had a diagnosis of BPH (P = .30), and 109 (1.5%) and 141 (2.0%) of case and control patients, respectively, had been exposed to finasteride prior to the index date (matched odds ratio, 0.77; 95% confidence interval, 0.59-1.00; P = .04). There was no suggestion of a dose-response relationship between exposure to 5-alpha reductase inhibitors when the exposure was stratified into tertiles of total exposure (P = .12). By contrast, there was a slightly higher prevalence of alpha-blocker use in case vs control patients (32% vs 30%, respectively; P = .04). CONCLUSIONS Exposure to 5-alpha reductase inhibitors was not associated with increased risk of hip fracture. The reduction in risk observed with exposure to 5-alpha reductase inhibitors and the modest increase in risk associated with exposure to alpha-blockers require replication and warrant further investigation.
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Affiliation(s)
- Steven J Jacobsen
- Department of Research and Evaluation, Kaiser Permanente Southern California, 100 S Los Robles Ave, Second Floor, Pasadena, CA 91101, USA.
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83
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Finasteride for prevention of prostate cancer. Med Lett Drugs Ther 2008; 50:49-50. [PMID: 18583946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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84
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Abstract
Finasteride is a specific inhibitor of the 5alpha reductase enzyme originally approved for the treatment of benign prostatic hypertrophy and also for the treatment of androgenetic alopecia (AGA) in men at a dose of 1 mg/day. We report on three cases of young men recruited at our Centre for Male Infertility who had used finasteride for five years. Semen quality was investigated by light microscopy to evaluate sperm concentration and motility. Sperm morphology was performed by transmission electron microscope (TEM) and the data were analyzed. The presence of Y microdeletions was investigated by PCR. Meiotic segregation was explored by fluorescence in situ hybridization (FISH). Patient 1 was azoospermic, patients 2 and 3 showed a normal sperm concentration and severely reduced progressive motility. TEM analysis revealed altered sperm morphology consistent with necrosis and FISH data revealed elevated diploidy and sex chromosome disomy frequencies. This examination was repeated 1 year after the men had suspended the use of finasteride, without receiving any other treatment. A recovery of spermatogenetic process was observed. Motility and morphology improved whereas the meiotic pattern did not change presenting elevated diploidy and sex chromosome disomy frequency.
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Affiliation(s)
- Giulia Collodel
- Department of Surgery, Biology Section, Interdepartmental Centre for Research and Therapy of Male Infertility, University of Siena, Policlinico Le Scotte, Viale Bracci 14, 53100 Siena, Italy
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85
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Matoka DJ, Averch TD. Predictability of irritative voiding symptoms following photoselective laser vaporization of the prostate. Can J Urol 2007; 14:3710-3714. [PMID: 17949529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Photoselective laser vaporization of the prostate (PVP) is recognized as an alternative for the surgical management of BPH. Our experience suggests a higher incidence of persistent irritative symptoms than expected. Characteristics of our population were evaluated to determine whether postoperative symptomatology could be predicted. METHODS We retrospectively reviewed those patients who underwent PVP at our institution between June 2004 and February 2006. Lower urinary tract symptoms as measured by the American Urological Association Symptom Index (AUA-SI) score and quality of life (QoL) score were recorded. In addition, peak urinary flow rate (Qmax) and ultrasound prostate volumes were also measured. PVP was performed using an 80 W KTP side-firing laser (LaserScope, San Jose, CA). Total energy used was recorded. AUA-SI score, QoL and Qmax were monitored at 1, 3 and 6 months postoperatively. RESULTS Twenty-nine men were evaluated retrospectively. Their mean AUA-SI score, prostate volume and energy used were 17.8, 49.8 cm3 and 96.8 kJ respectively. At 1 month, 34 % complained of significant urgency, frequency and dysuria. Anticholinergic therapy was initiated in six patients. At 6 months, the number of patients complaining of symptoms decreased to 17% and five of the six patients were no longer requiring therapy. An association between finasteride therapy prior to PVP and post-operative symptoms was identified. In our series, 70% of those patients experiencing persistent symptoms had been managed with finasteride. No association between irritative voiding symptoms, laser energy utilized and volume of treated prostate gland was observed. However, a statistically significant association was noted between persistent irritative voiding symptoms and both lower preoperative AUA-SI scores and preoperative use of finasteride. CONCLUSIONS Although a therapeutic benefit is observed following PVP, persistent irritative voiding symptoms are not uncommon. Lower preoperative AUA-SI scores and treatment with finasteride appear to be associated with bothersome postoperative symptoms. This information can be used to effectively select candidates and to counsel those patients with regard to both the therapeutic objective and expectations related to this procedure.
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Affiliation(s)
- Derek J Matoka
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213-3232, USA
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86
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Abstract
The Prostate Cancer Prevention Trial (PCPT) has been the first interventional trial directly aimed at the prevention of prostate cancer. A total of 18,882 men over 55 years with a PSA serum level less than 3.0 ng/ml were randomized to receive either the 5-alpha-reductase inhibitor finasteride 5 mg/day or placebo for 7 years. Despite a 25% reduction of prostate cancers in the treatment arm the results were discussed controversially. This criticism was mainly due to the observation of significantly more high-grade cancers in the finasteride group. Meanwhile, results of extensive follow-up analyses have been published suggesting that this finding is most likely due to optimized tumor detection in smaller glands. Further work-up demonstrated that PSA diagnosis and the histopathological examination were not compromised by finasteride. Furthermore, in addition to a decrease of prostate cancer the amount of prostatic intraepithelial dysplasia (PIN) was also reduced under finasteride. Future research must now aim at defining high-risk groups specifically profiting from chemoprevention with a 5-alpha-reductase inhibitor.
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87
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Finasteride: new indication. Benign prostatic hypertrophy: sexual disorders. Prescrire Int 2007; 16:147. [PMID: 17724838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
About 10 fewer cases of acute urinary retention and surgery per 1000 patient-years of treatment . . . but about 30 treatment withdrawals due to sexual disorders.
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88
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Wu YG, Li SK, Xin ZC, Wang YS, Shou KR, Gao H, Li YQ. [The establishment of hypospadias rat model and embryoteratogenic test of Atrazine]. Zhonghua Zheng Xing Wai Ke Za Zhi 2007; 23:340-343. [PMID: 17926863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To establish an easily reproducible animal model of hypospadias and to test whether Atrazine can induce hypospadias in animal experiment. METHODS From the 11th to 16th day after conception, 120 conceived SD rats were divided randomly into 6 groups: one coin oil group (1 ml/kg/d), two finasteride groups (10 mg/kg/d, 20 mg/kg/d), three Atrazine groups (25 mg/kg/d, 100 mg/kg/d, 200 mg/kg/d). When all pregnant rats had delivered, the new born rats were counted and the penis appearance, urethral orifice position and micturition were observed with magnifying lens and anatomy microscope. RESULTS Hypospadias were found in new born male rats treated prenatally with Finasteride (10 mg/kg/d, 20 mg/kg/d) and 200 mg/kg/d Atrazine groups. The incidence was 28.30%, 67.03%, 10.23% respectively. Embryotoxic effects were observed at 25 mg/kg/d Atrazine group in 2 rats and associated with no severe maternal toxicity. CONCLUSIONS (1) A hypospadias SD rats model can be established by Finasteride and it is easily reproducible. (2) The Atrazine was teratogenic to the SD rats, embryotoxic effects were observed at the low dose level and associated with no severe maternal toxicity.
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Affiliation(s)
- Yi-guang Wu
- Plastic Surgery Hospital, Chinese Academy of Medical Science, Beijing 100041, China
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89
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Schmitz-Dräger BJ, Lümmen G, Schäfer RM. Chemoprävention des Prostatakarzinoms. Urologe A 2007; 46:611-5. [PMID: 17483928 DOI: 10.1007/s00120-007-1352-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Fueled by the results from recently published large interventional trials the topic of chemoprevention of prostate cancer has increasingly attracted the interest of practicing urologists. In this analysis the term"chemoprevention" comprises all agents not included in regular food intake. If possible, the results from interventional studies were considered. Today, it must be accepted as evidence-based that chemoprevention of prostate cancer by 5alpha-reductase inhibition using finasteride is possible. Furthermore, there is increasing evidence that selective estrogen receptor modulators (SERMs) may also have preventive potential. Prospective interventional trials investigating these substances are currently underway. Considering the high incidence and the fact that the diagnosis of prostate cancer has serious impact on the future life of the respective individuals further scientific evaluation of chemoprevention of prostate cancer is mandatory.
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90
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Al Hammadi A, Asai Y, Patt ML, Sasseville D. Erythema annulare centrifugum secondary to treatment with finasteride. J Drugs Dermatol 2007; 6:460-3. [PMID: 17668547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Cutaneous eruptions are among the most common adverse reactions to drugs. We report a novel case of erythema annulare centrifugum occurring after the administration of finasteride for androgenetic alopecia. The eruption resolved once the drug was discontinued and reappeared with reintroduction of finasteride. This case may encourage reporting of similar cases and further study of finasteride hypersensitivity.
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Affiliation(s)
- Anwar Al Hammadi
- Division of Dermatology, McGill University Health Centre, Faculty of Medicine, Montreal, Canada.
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91
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Murtola TJ, Tammela TLJ, Määttänen L, Hakama M, Auvinen A. Prostate cancer risk among users of finasteride and alpha-blockers - a population based case-control study. Eur J Cancer 2007; 43:775-81. [PMID: 17251005 DOI: 10.1016/j.ejca.2006.12.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2006] [Revised: 11/30/2006] [Accepted: 12/01/2006] [Indexed: 11/28/2022]
Abstract
Finasteride has been reported to reduce prostate cancer risk in asymptomatic men. However, in clinical practice finasteride and alpha-blockers are used to treat benign prostatic hyperplasia (BPH). We evaluated prostate cancer risk among users of BPH pharmacotherapy at the population level. Comprehensive Finnish national registries provided information on 24723 prostate cancer cases and controls. Overall, prostate cancer risk was elevated among users of both drug categories compared to non-users (odds ratio, OR=1.41; 95% confidence interval, CI 1.31-1.51 for finasteride and OR=1.79; 95% CI 1.67-1.91 for alpha-blockers). However, the risk was lower among finasteride users when compared with alpha-blocker users (OR=0.80; 95% CI 0.64-1.00). Regular finasteride users had the lowest risk. The increased risk is probably due to enhanced diagnostics of prostate cancer in men with BPH. Finasteride use does not decrease prostate cancer incidence compared with non-users. Nevertheless, the risk is lower when compared with alpha-blocker users.
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Affiliation(s)
- Teemu J Murtola
- University of Tampere, School of Public Health, 33014 Tampere, Finland.
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92
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Abstract
BACKGROUND Enlargement of the prostate is common among aging men, with an incidence of 90% by the age of 85 years. It is a progressive condition, with growth in prostate size accompanied by lower urinary tract symptoms that can result in long-term complications (eg, acute urinary retention [AUR], need for enlarged prostate-related surgery). Current pharmacologic treatment options include alpha-blockers (alfuzosin, doxazosin, tamsulosin, and terazosin) and 5alpha-reductase inhibitors (5ARIs) (finasteride and dutasteride). OBJECTIVES This article reviews the natural history of enlarged prostate and the data supporting management of this condition with alpha-blocker and 5ARI therapy, either as monotherapy or combination therapy, for symptomatic relief and a reduction in long-term disease progression. METHODS Pertinent English-language articles were identified through a search of MEDLINE (1966-week 2, May 2006) using such search terms as 5alpha-reductase inhibitor, alpha-blocker, benign prostatic hyperplasia, dutasteride, efficacy, enlarged prostate, finasteride, and safety. RESULTS Clinical trials of alpha-blockers in men with enlarged prostate have reported improvements in total symptom scores of 10% to 20% compared with placebo; however, these agents were not shown to reduce the risk of long-term complications or disease progression. Studies of the 5ARIs have reported significant reductions compared with placebo in the relative risk for AUR and enlarged prostate-related surgery, slowing of disease progression, and relief of symptoms. In studies of dutasteride, improvements in symptom scores were greater after 4 years of therapy compared with 2 years (-6.4 vs -4.3 points, respectively) and flow rates were better (2.6 vs 2.3 mL/sec). Six-year data for finasteride showed maintenance of the decreased risk for AUR and enlarged prostate-related surgery. Use of combination therapy with an alpha-blocker and a 5ARI may be of benefit in patients who require immediate relief of symptoms, with discontinuation of the alpha-blocker after several months of therapy. 5ARIs were generally well tolerated, with sexual dysfunction the most frequently reported adverse effect, although in only a small proportion of men (1%-8%). CONCLUSIONS The use of 5ARI therapy is a rational approach to symptom management and prevention of long-term negative outcomes in men with enlarged prostates.V 3.
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Affiliation(s)
- Michael J Naslund
- University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.
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93
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Olsen EA, Hordinsky M, Whiting D, Stough D, Hobbs S, Ellis ML, Wilson T, Rittmaster RS. The importance of dual 5alpha-reductase inhibition in the treatment of male pattern hair loss: results of a randomized placebo-controlled study of dutasteride versus finasteride. J Am Acad Dermatol 2006; 55:1014-23. [PMID: 17110217 DOI: 10.1016/j.jaad.2006.05.007] [Citation(s) in RCA: 158] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2006] [Revised: 03/29/2006] [Accepted: 05/05/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND Male pattern hair loss (MPHL) is a potentially reversible condition in which dihydrotestosterone is an important etiologic factor. OBJECTIVE Our aim was to evaluate the efficacy of the type 1 and 2 5alpha-reductase inhibitor dutasteride in men with MPHL. METHODS Four hundred sixteen men, 21 to 45 years old, were randomized to receive dutasteride 0.05, 0.1, 0.5 or 2.5 mg, finasteride 5 mg, or placebo daily for 24 weeks. RESULTS Dutasteride increased target area hair count versus placebo in a dose-dependent fashion and dutasteride 2.5 mg was superior to finasteride at 12 and 24 weeks. Expert panel photographic review and investigator assessment of hair growth confirmed these results. Scalp and serum dihydrotestosterone levels decreased, and testosterone levels increased, in a dose-dependent fashion with dutasteride. LIMITATIONS The study was limited to 24 weeks. CONCLUSION Dutasteride increases scalp hair growth in men with MPHL. Type 1 and type 2 5alpha-reductase may be important in the pathogenesis and treatment of MPHL.
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Affiliation(s)
- Elise A Olsen
- Duke University Medical Center, Durham, North Carolina, USA.
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94
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Hoque A. The evolution of the PCPT from clinical to molecular analyses. ACTA ACUST UNITED AC 2006; 3:581. [PMID: 17080169 DOI: 10.1038/ncponc0653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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95
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Rahimi-Ardabili B, Pourandarjani R, Habibollahi P, Mualeki A. Finasteride induced depression: a prospective study. BMC Clin Pharmacol 2006; 6:7. [PMID: 17026771 PMCID: PMC1622749 DOI: 10.1186/1472-6904-6-7] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/04/2006] [Accepted: 10/07/2006] [Indexed: 11/18/2022]
Abstract
Background Finasteride is a competitive inhibitor of 5 alpha-reductase enzyme, and is used for treatment of benign prostatic hyperplasia and androgenetic alopecia. Animal studies have shown that finasteride might induce behavioral changes. Additionally, some cases of finasteride-induced depression have been reported in humans. The purpose of this study was to examine whether depressive symptoms or anxiety might be induced by finasteride administration. Methods One hundred and twenty eight men with androgenetic alopecia, who were prescribed finasteride (1 mg/day) were enrolled in this study. Information on depressed mood and anxiety was obtained by Beck Depression Inventory (BDI), and Hospital Anxiety and Depression Scale (HADS). Participants completed BDI and HADS questionnaires before beginning the treatment and also two months after it. Results Mean age of the subjects was 25.8(± 4.4) years. At baseline, mean BDI and HADS depression scores were 12.11(± 7.50) and 4.04(± 2.51), respectively. Finasteride treatment increased both BDI (p < 0.001) and HADS depression scores significantly (p = 0.005). HADS anxiety scores were increased, but the difference was not significant (p = 0.061). Conclusion This preliminary study suggests that finasteride might induce depressive symptoms; therefore this medication should be prescribed cautiously for patients with high risk of depression. It seems that further studies would be necessary to determine behavioral effects of this medication in higher doses and in more susceptible patients.
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Affiliation(s)
- Babak Rahimi-Ardabili
- Clinical Pharmacy Laboratory, Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ramin Pourandarjani
- Sina's clinic of Dermatology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Peiman Habibollahi
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Mualeki
- Clinical Pharmacy Laboratory, Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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96
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Bogdanov AB, Luk'ianov IV, Veliev EI. [Using doxasosine and finasteride combination in the treatment of prostate adenoma]. Urologiia 2006:59-63. [PMID: 17444154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The study was made in 2005-2006 of efficacy and safety of combined use of doxasosine and finasteride in patients (n = 50, age 53-83) with symptoms of lower urinary tract dysfunction (LUTD) caused by prostatic adenoma. LUTD severity by IPSS, size of the prostate, maximal and mean urinary flow velocity, functional capacity of the urinary bladder, residual urine, blood pressure, a PSA level, sexual function, were assessed at baseline and after the treatment. Side effects were also registered. Combined treatment with doxasosine plus finasteride significantly lowered both obstructive and irritative LUTD symptoms by IPSS, quality of life improved from 3.4 to 2.3 scores (p < 0.01), maximal urinary flow and mean urinary flow velocity increased from 10.2 to 11.6 ml/s and from 5.4 to 6.1 ml/s, respectively, residual urine reduced from 35.2 to 7.7 ml (p < 0.01). The size of the prostate diminished from 55.8 to 46 cm(3) (p < 0.01). PSA decreased from 2.8 to 1.4 ng/ml. Erectile function did not worsen. Thus, the proposed scheme of combined treatment improves quality of life, voiding; lowers residual urine; is well tolerated; can be recommended as a basic scheme of treatment in patients with a risk of prostatic adenoma progression.
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97
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Tejani A, Musini V, Perry TL, Mintzes B, Wright JM. Benign prostatic hypertrophy: update on drug therapy. Can Fam Physician 2006; 52:1075-6, 1077-8. [PMID: 17279217 PMCID: PMC1783734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
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98
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99
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Abstract
CONCLUSIONS A subgroup of patients with idiopathic sensorineural hearing loss (SNHL) will have steroid-dependent symptoms which can be confirmed using pure-tone audiometry. Long-term treatment with high-dose corticosteroids exposes patients to potentially serious adverse effects. Immunosuppression with ciclosporin can be an effective and well-tolerated treatment for steroid-responsive sudden SNHL. OBJECTIVE To highlight ciclosporin as a therapeutic option in the treatment of steroid-responsive sudden SNHL. MATERIAL AND METHODS A 39-year-old male with idiopathic sudden SNHL that was responsive to corticosteroids was treated with ciclosporin for 18 months. RESULTS Steroid-dependent SNHL was confirmed on audiological evaluation. Ciclosporin was administered, allowing corticosteroid therapy to be discontinued. Ciclosporin was effective at controlling all symptoms of SNHL. Remission was confirmed objectively with pure-tone audiometry.
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Affiliation(s)
- Lisha McClelland
- Department of Otolaryngology, Head and Neck Surgery, Queen's Medical Centre, Nottingham, UK.
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100
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Finasteride and minoxidil for alopecia revisited. Med Lett Drugs Ther 2005; 47:95-6. [PMID: 16299452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
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