Literature DB >> 8911291

Efficacy and safety of finasteride therapy for benign prostatic hyperplasia: results of a 2-year randomized controlled trial (the PROSPECT study). PROscar Safety Plus Efficacy Canadian Two year Study.

J C Nickel1, Y Fradet, R C Boake, P J Pommerville, J P Perreault, S K Afridi, M M Elhilali.   

Abstract

OBJECTIVE: To evaluate the efficacy and safety of 2 years' treatment of moderate benign prostatic hyperplasia (BPH) with finasteride.
DESIGN: Double-blind, parallel-group, placebo-controlled, multicentre, prospective randomized study.
SETTING: Outpatient care in 28 centres across Canada. PARTICIPANTS: Men aged 45 to 80, in good health, with moderate BPH and no evidence of prostate cancer. A total of 613 men were entered into the study; 472 completed the 2 years of treatment. INTERVENTION: After 1 month of receiving a placebo (run-in period), patients were given either finasteride (5 mg/d) or a placebo for 2 years. EFFICACY: changes from baseline in BPH symptom scores, maximum urinary flow rates and prostate volume. SAFETY: onset, course and resolution of all adverse events during the treatment period.
RESULTS: In the efficacy analyses the mean BPH symptom scores decreased 2.1 points (from 15.8 to 13.7) in the finasteride group, as compared with a decrease of 0.7 points (from 16.6 to 15.9) in the placebo group (P < or = 0.01). The maximum urinary flow rate increased by a mean of 1.4 mL/s (from 11.1 to 12.5 mL/s) in the finasteride group, as compared with an increase of 0.3 mL/s (from 10.9 to 11.2 mL/s) in the placebo group (p < or = 0.01). The mean prostate volume decreased by 21% (from a mean volume of 44.1 cm3 at baseline) in the treatment group; it increased by 8.4% (from a mean volume of 45.8 cm3 at baseline) in the placebo group (p < or = 0.01). In the safety analysis, the proportion of patients who experienced any adverse event was similar in the two groups (81.0% in the treatment group and 81.2% in the placebo group). However, the incidence of adverse events related to sexual dysfunction were significantly higher in the finasteride group than in the placebo group (ejaculation disorder 7.7% v. 1.7% and impotence 15.8% v. 6.3%; p < or = 0.01 for both parameters).
CONCLUSION: Finasteride is a well-tolerated and effective alternative to watchful waiting in the treatment of moderate BPH.

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Year:  1996        PMID: 8911291      PMCID: PMC1335066     

Source DB:  PubMed          Journal:  CMAJ        ISSN: 0820-3946            Impact factor:   8.262


  13 in total

1.  Relationship of symptoms of prostatism to commonly used physiological and anatomical measures of the severity of benign prostatic hyperplasia.

Authors:  M J Barry; A T Cockett; H L Holtgrewe; J D McConnell; S A Sihelnik; H N Winfield
Journal:  J Urol       Date:  1993-08       Impact factor: 7.450

2.  A multicenter, randomized, double-blind, placebo-controlled study to evaluate the safety and efficacy of terazosin in the treatment of benign prostatic hyperplasia.

Authors:  M M Elhilali; E W Ramsey; J Barkin; R W Casey; R C Boake; G Beland; Y Fradet; J Trachtenberg; W L Orovan; E Schick; L H Klotz
Journal:  Urology       Date:  1996-03       Impact factor: 2.649

3.  Comparison of the alpha-adrenoceptor characteristics in human and canine prostate.

Authors:  J P Hieble; A J Boyce; M Caine
Journal:  Fed Proc       Date:  1986-10

4.  Familial incomplete male pseudohermaphroditism, type 2. Decreased dihydrotestosterone formation in pseudovaginal perineoscrotal hypospadias.

Authors:  P C Walsh; J D Madden; M J Harrod; J L Goldstein; P C MacDonald; J D Wilson
Journal:  N Engl J Med       Date:  1974-10-31       Impact factor: 91.245

5.  A urodynamic view of prostatic obstruction and the results of prostatectomy.

Authors:  R T Warwick; C G Whiteside; E P Arnold; C P Bates; P H Worth; E G Milroy; J R Webster; J Weir
Journal:  Br J Urol       Date:  1973-12

6.  Scandinavian clinical study of finasteride in the treatment of benign prostatic hyperplasia.

Authors:  H O Beisland; B Binkowitz; E Brekkan; P Ekman; M Kontturi; T Lehtonen; P Lundmo; F Pappas; E Round; D Shapiro
Journal:  Eur Urol       Date:  1992       Impact factor: 20.096

7.  Maintenance of clinical efficacy with finasteride therapy for 24 months in patients with benign prostatic hyperplasia. The Finasteride Study Group.

Authors:  E Stoner
Journal:  Arch Intern Med       Date:  1994-01-10

8.  Natural history of prostatism: longitudinal changes in voiding symptoms in community dwelling men.

Authors:  S J Jacobsen; C J Girman; H A Guess; T Rhodes; J E Oesterling; M M Lieber
Journal:  J Urol       Date:  1996-02       Impact factor: 7.450

9.  Three-year safety and efficacy data on the use of finasteride in the treatment of benign prostatic hyperplasia.

Authors:  E Stoner
Journal:  Urology       Date:  1994-03       Impact factor: 2.649

10.  A comparison of transurethral surgery with watchful waiting for moderate symptoms of benign prostatic hyperplasia. The Veterans Affairs Cooperative Study Group on Transurethral Resection of the Prostate.

Authors:  J H Wasson; D J Reda; R C Bruskewitz; J Elinson; A M Keller; W G Henderson
Journal:  N Engl J Med       Date:  1995-01-12       Impact factor: 91.245

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  40 in total

Review 1.  The use of baseline clinical measures to predict those at risk for progression of benign prostatic hyperplasia.

Authors:  Edward D Kim
Journal:  Curr Urol Rep       Date:  2004-08       Impact factor: 3.092

Review 2.  Placebo Medication and Sham Surgery Responses in Benign Prostatic Hyperplasia Treatments: Implications for Clinical Trials.

Authors:  Igor Sorokin; Adam Schatz; Charles Welliver
Journal:  Curr Urol Rep       Date:  2015-10       Impact factor: 3.092

Review 3.  Adverse effects of 5α-reductase inhibitors: What do we know, don't know, and need to know?

Authors:  Abdulmaged M Traish; Roberto Cosimo Melcangi; Marco Bortolato; Luis M Garcia-Segura; Michael Zitzmann
Journal:  Rev Endocr Metab Disord       Date:  2015-09       Impact factor: 6.514

4.  The potential for prostate cancer chemoprevention.

Authors:  Otis W Brawley
Journal:  Rev Urol       Date:  2002

Review 5.  Investigation of the Plausibility of 5-Alpha-Reductase Inhibitor Syndrome.

Authors:  Raymond Fertig; Jerry Shapiro; Wilma Bergfeld; Antonella Tosti
Journal:  Skin Appendage Disord       Date:  2016-09-23

6.  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

Review 7.  Impact of alpha blockers, 5-alpha reductase inhibitors and combination therapy on sexual function.

Authors:  Charles Welliver; Michael Butcher; Yogitha Potini; Kevin T McVary
Journal:  Curr Urol Rep       Date:  2014-10       Impact factor: 3.092

8.  Persistent sexual dysfunction and depression in finasteride users for male pattern hair loss: a serious concern or red herring?

Authors:  Meena K Singh; Marc Avram
Journal:  J Clin Aesthet Dermatol       Date:  2014-12

Review 9.  The Impact of 5α-Reductase Inhibitor Use for Male Pattern Hair Loss on Men's Health.

Authors:  Mohammed A Said; Akanksha Mehta
Journal:  Curr Urol Rep       Date:  2018-06-16       Impact factor: 3.092

10.  Finasteride-its impact on sexual function and prostate cancer.

Authors:  B Anitha; Arun C Inamadar; S Ragunatha
Journal:  J Cutan Aesthet Surg       Date:  2009-01
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