The role of 5-α-reductase inhibition as monotherapy in view of the MTOPS data
Medical treatment for the symptoms of benign prostatic hyperplasia (BPH) consists of α blockers and 5-α-reductase inhibitors. Data suggest that 5-α-reductase inhibitors can prevent progression of BPH and reduce the risk of BPH-related surgery, especially in men with large-volume prostates. Results from the largest randomized, prospective, placebo-controlled trial, the Medical Therapy of Prostatic Symptoms trial, have been presented. These results support the notion of using 5-α-reductase inhibitors for the prevention of BPH progression and BPH-related surgery. Furthermore, long-term 5-α-reductase inhibitor monotherapy, although slow in onset, is a viable therapy for symptom relief in men with mild to moderate symptoms.
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References and Recommended Reading
- 4.McConnell JD, Barry MJ, Bruskewitz RC, et al.: Benign Prostatic Hyperplasia: Diagnosis and Treatment. Clinical Practice Guidelines. No. 8., AHCPR Publication No 94-0582. Rockville, MD: Agency for Health Care Policy and Research. Public Health Service, US Department of Health and Human Services, 1994.Google Scholar
- 7.Roehrborn CG, Boyle P, Bergner D, et al.: Serum prostate-specific antigen and prostate volume predict long-term changes in symptoms and flow rate: results of a 4-year, randomized trial comparing finasteride versus placebo. Urology 1999, 54:662–669. The first long-term study of 5-á-reductase, finasteride, in the treatment of BPH documenting safety and efficacy in a multicenter, randomized, placebo-controlled trial.PubMedCrossRefGoogle Scholar
- 15.AUA Practice Guideline Committee: AUA Guidelines on management of benign prostatic hyperplasia (2003). Chapter 1: diagnosis and treatment recommendations. J Urol 2003, 170:530–547. The recent publication of practice guidelines on the management of BPH by an AUA guideline committee. This publication is an update of the AHCPR guideline published in 1994.CrossRefGoogle Scholar
- 25.McConnell J: The impact of medical therapy on clinical progression of BPH: results of MTOPS trial [Abstract]. J Urol 2002, 1042:265. The first public presentation of the MTOPS data at the national AUA meeting.Google Scholar
- 26.Roehrborn CG, Boyle P, Nickel JC, et al.: Efficacy and safety of a dual inhibitor of 5-alpha-reductase types 1 and 2 (dutasteride) in men with benign prostatic hyperplasia. Urology 2002, 60:434–441. This study confirmed the safety and efficacy of 5-á-reductase therapy with a dual type-1 and type-2 5-á-reductase inhibitor therapy.PubMedCrossRefGoogle Scholar