Literature DB >> 21334655

Long-term treatment with finasteride improves clinical progression of benign prostatic hyperplasia in men with an enlarged versus a smaller prostate: data from the MTOPS trial.

Steven A Kaplan1, Jeannette Y Lee, Alan G Meehan, John W Kusek.   

Abstract

PURPOSE: This post hoc analysis of the Medical Therapy of Prostatic Symptoms trial examined the effect of finasteride alone compared to placebo on the clinical progression of benign prostatic hyperplasia in men with a baseline prostate volume less than 30 ml, or 30 ml or greater.
MATERIALS AND METHODS: Men were randomized to placebo (737), 4 to 8 mg doxazosin alone (756), 5 mg finasteride alone (768) or doxazosin plus finasteride (786) (average followup was 4.5 years). Approximately 50% of patients had a baseline prostate volume of 30 ml or greater. The present analysis was based on the finasteride alone and placebo arms only, and included patients for whom baseline and end of study data were available. We examined the effect of treatment on the cumulative percentage of men who did not experience clinical progression of benign prostatic hyperplasia by study end.
RESULTS: In men with baseline prostate volume 30 ml or greater treatment with finasteride produced a significant (p <0.001) increase relative to placebo in the cumulative percentage of patients who did not experience clinical progression of benign prostatic hyperplasia (finasteride 88.1% vs placebo 77.8%). There was no significant (p = 0.441) between-group difference in men with baseline prostate volume less than 30 ml (91.4% vs 89.1%, respectively).
CONCLUSIONS: Long-term treatment with finasteride led to a significant beneficial effect compared to placebo on the clinical progression of benign prostatic hyperplasia in patients with lower urinary tract symptoms with an enlarged prostate (baseline prostate volume 30 ml or greater). Finasteride had no significant effect compared to placebo on the clinical progression of benign prostatic hyperplasia in patients with lower urinary tract symptoms with a smaller prostate (baseline prostate volume less than 30 ml).
Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

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Year:  2011        PMID: 21334655      PMCID: PMC3677556          DOI: 10.1016/j.juro.2010.11.060

Source DB:  PubMed          Journal:  J Urol        ISSN: 0022-5347            Impact factor:   7.450


  8 in total

1.  AUA guideline on management of benign prostatic hyperplasia (2003). Chapter 1: Diagnosis and treatment recommendations.

Authors: 
Journal:  J Urol       Date:  2003-08       Impact factor: 7.450

2.  Statistics in medicine--reporting of subgroup analyses in clinical trials.

Authors:  Rui Wang; Stephen W Lagakos; James H Ware; David J Hunter; Jeffrey M Drazen
Journal:  N Engl J Med       Date:  2007-11-22       Impact factor: 91.245

3.  Study design of the Medical Therapy of Prostatic Symptoms (MTOPS) trial.

Authors:  Oliver M Bautista; John W Kusek; Leroy M Nyberg; John D McConnell; Raymond P Bain; Gary Miller; E David Crawford; Steven A Kaplan; Stephen A Sihelnik; Michael K Brawer; Hebert Lepor
Journal:  Control Clin Trials       Date:  2003-04

4.  Treatment for benign prostatic hyperplasia among community dwelling men: the Olmsted County study of urinary symptoms and health status.

Authors:  S J Jacobsen; D J Jacobson; C J Girman; R O Roberts; T Rhodes; H A Guess; M M Lieber
Journal:  J Urol       Date:  1999-10       Impact factor: 7.450

5.  The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. Finasteride Long-Term Efficacy and Safety Study Group.

Authors:  J D McConnell; R Bruskewitz; P Walsh; G Andriole; M Lieber; H L Holtgrewe; P Albertsen; C G Roehrborn; J C Nickel; D Z Wang; A M Taylor; J Waldstreicher
Journal:  N Engl J Med       Date:  1998-02-26       Impact factor: 91.245

6.  Combination therapy with doxazosin and finasteride for benign prostatic hyperplasia in patients with lower urinary tract symptoms and a baseline total prostate volume of 25 ml or greater.

Authors:  Steven A Kaplan; John D McConnell; Claus G Roehrborn; Alan G Meehan; Michael W Lee; William R Noble; John W Kusek; Leroy M Nyberg
Journal:  J Urol       Date:  2006-01       Impact factor: 7.450

7.  The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia.

Authors:  John D McConnell; Claus G Roehrborn; Oliver M Bautista; Gerald L Andriole; Christopher M Dixon; John W Kusek; Herbert Lepor; Kevin T McVary; Leroy M Nyberg; Harry S Clarke; E David Crawford; Ananias Diokno; John P Foley; Harris E Foster; Stephen C Jacobs; Steven A Kaplan; Karl J Kreder; Michael M Lieber; M Scott Lucia; Gary J Miller; Mani Menon; Douglas F Milam; Joe W Ramsdell; Noah S Schenkman; Kevin M Slawin; Joseph A Smith
Journal:  N Engl J Med       Date:  2003-12-18       Impact factor: 91.245

8.  Long-term treatment with finasteride results in a clinically significant reduction in total prostate volume compared to placebo over the full range of baseline prostate sizes in men enrolled in the MTOPS trial.

Authors:  Steven A Kaplan; Claus G Roehrborn; John D McConnell; Alan G Meehan; Shailaja Surynawanshi; Jeannette Y Lee; Jennifer Rotonda; John W Kusek; Leroy M Nyberg
Journal:  J Urol       Date:  2008-07-17       Impact factor: 7.450

  8 in total
  12 in total

1.  Evidence-based guidelines for the treatment of lower urinary tract symptoms related to uncomplicated benign prostatic hyperplasia in Italy: updated summary from AURO.it.

Authors:  Sebastiano Spatafora; Antonio Casarico; Andrea Fandella; Caterina Galetti; Rodolfo Hurle; Elisa Mazzini; Ciro Niro; Massimo Perachino; Roberto Sanseverino; Giovanni Luigi Pappagallo
Journal:  Ther Adv Urol       Date:  2012-12

2.  Inhibitory effect of diosgenin on experimentally induced benign prostatic hyperplasia in rats.

Authors:  Jing Chen; Huai-Fen Zhang; Chao-Mei Xiong; Jin-Lan Ruan
Journal:  J Huazhong Univ Sci Technolog Med Sci       Date:  2016-12-07

3.  Glucocorticoids are induced while dihydrotestosterone levels are suppressed in 5-alpha reductase inhibitor treated human benign prostate hyperplasia patients.

Authors:  Renjie Jin; Connor Forbes; Nicole L Miller; Douglas Strand; Thomas Case; Justin M Cates; Hye-Young H Kim; Phillip Wages; Ned A Porter; Krystin M Mantione; Sarah Burke; James L Mohler; Robert J Matusik
Journal:  Prostate       Date:  2022-07-12       Impact factor: 4.012

4.  The Use of 5-Alpha Reductase Inhibitors to Manage Benign Prostatic Hyperplasia and the Risk of All-cause Mortality.

Authors:  Lauren P Wallner; Julia R DiBello; Bonnie H Li; Stephen K Van Den Eeden; Sheila Weinmann; Debra P Ritzwoller; Jill E Abell; Ralph D'Agostino; Ronald K Loo; David S Aaronson; Ralph I Horwitz; Steven J Jacobsen
Journal:  Urology       Date:  2018-06-12       Impact factor: 2.649

Review 5.  Is There a Role for Preoperative 5 Alpha Reductase Inhibitors in Reducing Prostate Vascularity and Blood Loss?

Authors:  Matthew Bruha; Charles Welliver
Journal:  Curr Urol Rep       Date:  2017-10       Impact factor: 3.092

6.  Cardiovascular Risk Factors and Ethnicity Are Independent Factors Associated with Lower Urinary Tract Symptoms.

Authors:  Jasmine Lim; Nirmala Bhoo-Pathy; Selvalingam Sothilingam; Rohan Malek; Murali Sundram; Guan Hee Tan; Badrulhisham Bahadzor; Teng Aik Ong; Keng Lim Ng; Azad Hassan Abdul Razack
Journal:  PLoS One       Date:  2015-06-22       Impact factor: 3.240

7.  Clinical Significance of Periurethral Calcification According to the Location in Men With Lower Urinary Tract Symptoms and a Small Prostate Volume.

Authors:  Jang Hee Han; Joo Yong Lee; Jong Kyu Kwon; Jong Soo Lee; Kang Su Cho
Journal:  Int Neurourol J       Date:  2017-09-12       Impact factor: 2.835

8.  Molecular Analysis of the SRD5A1 and SRD5A2 Genes in Patients with Benign Prostatic Hyperplasia with Regard to Metabolic Parameters and Selected Hormone Levels.

Authors:  Aleksandra Rył; Iwona Rotter; Anna Grzywacz; Iwona Małecka; Karolina Skonieczna-Żydecka; Katarzyna Grzesiak; Marcin Słojewski; Aleksandra Szylińska; Olimpia Sipak-Szmigiel; Małgorzata Piasecka; Kinga Walczakiewicz; Maria Laszczyńska
Journal:  Int J Environ Res Public Health       Date:  2017-10-30       Impact factor: 3.390

9.  Chinese urologists' views of practice patterns in the diagnosis and treatment of benign prostatic hyperplasia: a nationwide survey.

Authors:  Nan Wu; Jian Sun; Pulin Yu; Zhenqiu Sun
Journal:  Int Neurourol J       Date:  2012-12-31       Impact factor: 2.835

10.  Hormonal manipulation of lower urinary tract symptoms secondary to benign prostatic obstruction.

Authors:  Adita Raja; Satoshi Hori; James N Armitage
Journal:  Indian J Urol       Date:  2014-04
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