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Finasteride reduces the risk of incident clinical benign prostatic hyperplasia.

Abstract

BACKGROUND

Despite the high prevalence of clinical benign prostatic hyperplasia (BPH) among older men, there remains a notable absence of studies focused on BPH prevention.

OBJECTIVE

To determine if finasteride prevents incident clinical BPH in healthy older men.

DESIGN, SETTING, AND PARTICIPANTS

Data for this study are from the Prostate Cancer Prevention Trial. After excluding those with a history of BPH diagnosis or treatment, or an International Prostate Symptom Score (IPSS) ≥ 8 at study entry, 9253 men were available for analysis.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

The primary outcome was incident clinical BPH, defined as the initiation of medical treatment, surgery, or sustained, clinically significant urinary symptoms (IPSS >14). Finasteride efficacy was estimated using Cox proportional regression models to generate hazards ratios (HRs).

RESULTS AND LIMITATIONS

Mean length of follow-up was 5.3 yr. The rate of clinical BPH was 19 per 1000 person-years in the placebo arm and 11 per 1000 person-years in the finasteride arm (p<0.001). In a covariate-adjusted model, finasteride reduced the risk of incident clinical BPH by 40% (HR: 0.60; 95% confidence interval, 0.51-0.69; p<0.001). The effect of finasteride on incident clinical BPH was attenuated in men with a body mass index ≥ 30 kg/m(2) (p(interaction) = 0.04) but otherwise did not differ significantly by physical activity, age, race, current diabetes, or current smoking. The post hoc nature of the analysis is a potential study limitation.

CONCLUSIONS

Finasteride substantially reduces the risk of incident clinical BPH in healthy older men. These results should be considered in formulating recommendations for the use of finasteride to prevent prostate diseases in asymptomatic older men.

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  • Authors+Show Affiliations

    ,

    Division of Urologic Oncology, Moores Comprehensive Cancer Center and Section of Urology, San Diego Veterans Affairs Medical Center, University of California, San Diego, La Jolla, CA 92093-0987, USA. jkparsons@ucsd.edu

    , , , , , , ,

    Source

    European urology 62:2 2012 Aug pg 234-41

    MeSH

    5-alpha Reductase Inhibitors
    Aged
    Aged, 80 and over
    Finasteride
    Humans
    Male
    Middle Aged
    Prostate-Specific Antigen
    Prostatic Hyperplasia
    Risk
    Treatment Outcome

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22459892

    Citation

    Parsons, J Kellogg, et al. "Finasteride Reduces the Risk of Incident Clinical Benign Prostatic Hyperplasia." European Urology, vol. 62, no. 2, 2012, pp. 234-41.
    Parsons JK, Schenk JM, Arnold KB, et al. Finasteride reduces the risk of incident clinical benign prostatic hyperplasia. Eur Urol. 2012;62(2):234-41.
    Parsons, J. K., Schenk, J. M., Arnold, K. B., Messer, K., Till, C., Thompson, I. M., & Kristal, A. R. (2012). Finasteride reduces the risk of incident clinical benign prostatic hyperplasia. European Urology, 62(2), pp. 234-41. doi:10.1016/j.eururo.2012.03.007.
    Parsons JK, et al. Finasteride Reduces the Risk of Incident Clinical Benign Prostatic Hyperplasia. Eur Urol. 2012;62(2):234-41. PubMed PMID: 22459892.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Finasteride reduces the risk of incident clinical benign prostatic hyperplasia. AU - Parsons,J Kellogg, AU - Schenk,Jeannette M, AU - Arnold,Kathryn B, AU - Messer,Karen, AU - Till,Cathee, AU - Thompson,Ian M, AU - Kristal,Alan R, AU - ,, AU - ,, Y1 - 2012/03/14/ PY - 2012/01/06/received PY - 2012/03/05/accepted PY - 2012/3/31/entrez PY - 2012/3/31/pubmed PY - 2012/12/12/medline SP - 234 EP - 41 JF - European urology JO - Eur. Urol. VL - 62 IS - 2 N2 - BACKGROUND: Despite the high prevalence of clinical benign prostatic hyperplasia (BPH) among older men, there remains a notable absence of studies focused on BPH prevention. OBJECTIVE: To determine if finasteride prevents incident clinical BPH in healthy older men. DESIGN, SETTING, AND PARTICIPANTS: Data for this study are from the Prostate Cancer Prevention Trial. After excluding those with a history of BPH diagnosis or treatment, or an International Prostate Symptom Score (IPSS) ≥ 8 at study entry, 9253 men were available for analysis. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary outcome was incident clinical BPH, defined as the initiation of medical treatment, surgery, or sustained, clinically significant urinary symptoms (IPSS >14). Finasteride efficacy was estimated using Cox proportional regression models to generate hazards ratios (HRs). RESULTS AND LIMITATIONS: Mean length of follow-up was 5.3 yr. The rate of clinical BPH was 19 per 1000 person-years in the placebo arm and 11 per 1000 person-years in the finasteride arm (p<0.001). In a covariate-adjusted model, finasteride reduced the risk of incident clinical BPH by 40% (HR: 0.60; 95% confidence interval, 0.51-0.69; p<0.001). The effect of finasteride on incident clinical BPH was attenuated in men with a body mass index ≥ 30 kg/m(2) (p(interaction) = 0.04) but otherwise did not differ significantly by physical activity, age, race, current diabetes, or current smoking. The post hoc nature of the analysis is a potential study limitation. CONCLUSIONS: Finasteride substantially reduces the risk of incident clinical BPH in healthy older men. These results should be considered in formulating recommendations for the use of finasteride to prevent prostate diseases in asymptomatic older men. SN - 1873-7560 UR - https://www.unboundmedicine.com/medline/citation/22459892/Finasteride_reduces_the_risk_of_incident_clinical_benign_prostatic_hyperplasia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0302-2838(12)00317-X DB - PRIME DP - Unbound Medicine ER -