Literature DB >> 28487578

5α-Reductase Inhibitors for Treatment of Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis.

Jennifer E J Jun1, Angus Kinkade2, Anthony C H Tung3, Aaron M Tejani4.   

Abstract

BACKGROUND: Finasteride and dutasteride are competitive inhibitors of 5α-reductase enzymes and are commonly used to treat symptomatic benign prostatic hyperplasia (BPH).
OBJECTIVE: To compare the efficacy and safety of finasteride and dutasteride in terms of clinically important outcomes. DATA SOURCES: A literature search was performed using the search terms "prostatic hyperplasia", "prostatic hypertrophy", "dutasteride", "finasteride", "quality of life", "adverse drug reaction", and "mortality". The Embase, PubMed, Cochrane Central Register of Controlled Trials, International Pharmaceutical Abstracts, Cumulative Index to Nursing and Allied Health Literature, and Latin American and Caribbean Health Sciences Literature databases were searched from inception to December 2015. STUDY SELECTION AND DATA EXTRACTION: Randomized controlled trials, quasi-randomized trials, and systematic reviews comparing finasteride with dutasteride, either as monotherapy or in combination with α-blockers, for treatment of men with BPH were included. The outcomes of interest included need for prostate-related surgery, episodes of acute urinary retention, withdrawals due to adverse events, number of patients experiencing serious adverse events, mortality, and sexual dysfunction. DATA SYNTHESIS: Four studies involving a total of 1879 patients were included in the analysis. There were no significant differences in any of the clinically important outcomes examined: for prostate-related surgery, odds ratio (OR) 2.01 (95% confidence interval [CI] 0.18-22.24); for episodes of acute urinary retention, OR 1.47 (95% CI 0.68-3.19); for number of withdrawals due to adverse events, OR 1.10 (95% CI 0.68-1.75); for total number of patients experiencing adverse events, OR 0.94 (95% CI 0.78-1.14); for number of patients experiencing serious adverse events, OR 1.31 (95% CI 0.87-1.97); and for sexual dysfunction, OR 0.83 (95% CI 0.64-1.08).
CONCLUSION: There is insufficient evidence to suggest that either finasteride or dutasteride offers an advantage in efficacy or safety over the other, in terms of clinically important outcomes.

Entities:  

Keywords:  5α-reductase inhibitors; benign prostatic hyperplasia; benign prostatic hypertrophy; dutasteride; finasteride

Year:  2017        PMID: 28487578      PMCID: PMC5407420          DOI: 10.4212/cjhp.v70i2.1643

Source DB:  PubMed          Journal:  Can J Hosp Pharm        ISSN: 0008-4123


  13 in total

1.  Which clinical studies provide the best evidence? The best RCT still trumps the best observational study.

Authors:  S Barton
Journal:  BMJ       Date:  2000-07-29

2.  Comparison of dutasteride and finasteride for treating benign prostatic hyperplasia: the Enlarged Prostate International Comparator Study (EPICS).

Authors:  J Curtis Nickel; Peter Gilling; Teuvo L Tammela; Betsy Morrill; Timothy H Wilson; Roger S Rittmaster
Journal:  BJU Int       Date:  2011-06-01       Impact factor: 5.588

Review 3.  Observer bias in randomised clinical trials with binary outcomes: systematic review of trials with both blinded and non-blinded outcome assessors.

Authors:  Asbjørn Hróbjartsson; Ann Sofia Skou Thomsen; Frida Emanuelsson; Britta Tendal; Jørgen Hilden; Isabelle Boutron; Philippe Ravaud; Stig Brorson
Journal:  BMJ       Date:  2012-02-27

Review 4.  Efficacy and safety of dutasteride for the treatment of symptomatic benign prostatic hyperplasia (BPH): a systematic review and meta-analysis.

Authors:  Taehwan Park; Jae-Young Choi
Journal:  World J Urol       Date:  2014-02-06       Impact factor: 4.226

Review 5.  Impact of medical treatments for male lower urinary tract symptoms due to benign prostatic hyperplasia on ejaculatory function: a systematic review and meta-analysis.

Authors:  Mauro Gacci; Vincenzo Ficarra; Arcangelo Sebastianelli; Giovanni Corona; Sergio Serni; Shahrokh F Shariat; Mario Maggi; Filiberto Zattoni; Marco Carini; Giacomo Novara
Journal:  J Sex Med       Date:  2014-04-07       Impact factor: 3.802

6.  Comparison of clinical trials with finasteride and dutasteride.

Authors:  J Curtis Nickel
Journal:  Rev Urol       Date:  2004

7.  5-Alpha reductase inhibitors in men with an enlarged prostate: an evaluation of outcomes and therapeutic alternatives.

Authors:  Michael Naslund; Timothy S Regan; Christine Ong; Susan L Hogue
Journal:  Am J Manag Care       Date:  2008-05       Impact factor: 2.229

8.  Finasteride to evaluate the efficacy of dutasteride in the management of patients with lower urinary tract symptoms and enlarged prostate.

Authors:  I R Ravish; R B Nerli; S S Amarkhed
Journal:  Arch Androl       Date:  2007 Jan-Feb

9.  The role of dihydrotestosterone in benign prostatic hyperplasia.

Authors:  Culley Carson; Roger Rittmaster
Journal:  Urology       Date:  2003-04       Impact factor: 2.649

10.  Effect of discontinuation of 5alpha-reductase inhibitors on prostate volume and symptoms in men with BPH: a prospective study.

Authors:  Young Beom Jeong; Keun Sang Kwon; Sang Deuk Kim; Hyung Jin Kim
Journal:  Urology       Date:  2009-02-03       Impact factor: 2.649

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  3 in total

Review 1.  [Influence of medical BPS treatment on sexual function].

Authors:  T Bschleipfer; M Burkart
Journal:  Urologe A       Date:  2018-12       Impact factor: 0.639

2.  Astaxantin and Isoflavones Inhibit Benign Prostatic Hyperplasia in Rats by Reducing Oxidative Stress and Normalizing Ca/Mg Balance.

Authors:  Alexander L Semenov; Ekaterina A Gubareva; Elena D Ermakova; Anastasia A Dorofeeva; Irina A Tumanyan; Ekaterina A Radetskaya; Maria N Yurova; Saied A Aboushanab; Osman N Kanwugu; Elena I Fedoros; Andrey V Panchenko
Journal:  Plants (Basel)       Date:  2021-12-12

3.  6-sialyllactose ameliorates dihydrotestosterone-induced benign prostatic hyperplasia through suppressing VEGF-mediated angiogenesis.

Authors:  Eun-Yeong Kim; Bo-Ram Jin; Tae-Wook Chung; Sung-Jin Bae; Hyerin Park; Dongryeol Ryu; Ling Jin; Hyo-Jin An; Ki-Tae Ha
Journal:  BMB Rep       Date:  2019-09       Impact factor: 4.778

  3 in total

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