Current Pharmacological Treatment for Male LUTS due to BPH: Dutasteride or Finasteride?

Author(s): Luisella Pirozzi, Petros Sountoulides, Pietro Castellan, Fabrizio Presicce, Riccardo Lombardo, Marilena Romero, Cosimo De Nunzio, Andrea Tubaro, Luigi Schips, Luca Cindolo

Journal Name: Current Drug Targets

Volume 16 , Issue 11 , 2015

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Graphical Abstract:


Benign prostatic hyperplasia (BPH) is a potentially progressive disease which is commonly associated with bothersome lower urinary tract symptoms (LUTS) and might result in complications, such as acute urinary retention and BPH-related surgery. In the current medical therapy scenario for LUTS attributed to BPH, only one class of drugs, 5-α reductase inhibitors (5ARIs), has been found to be effective in reducing the risk of disease progression. The two 5ARIs that are currently available include finasteride and dutasteride. These two drugs have different pharmacokinetic and pharmacodynamic properties. Greater suppression of dehydrotestosterone is achieved by dutasteride (>90% dutasteride vs 70% finasteride) which theoretically should correlate with greater efficacy in alleviating urinary symptoms. Unfortunately, this hypothesis has not yet been clinically demonstrated. The pertinent literature is scarce and heterogeneous and produces low scientific levels of evidence. The present review article aims to evaluate the comparative head-to-head studies in order to evaluate if the hypothetical clinical differences between dutasteride and finasteride do exist. Pharmacological treatment with either drug results in similar symptom improvements; however dutasteride seems to have a better profile in reducing the risk of prostate surgery and acute urinary retention (AUR). More studies are necessary to better evaluate both the clinical and pharmacoeconomic profile of the two 5ARIs.

Keywords: 5-alpha reductase inhibitors, benign prostatic hyperplasia, dutasteride, finasteride, lower urinary tract symptoms, review.

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Article Details

Year: 2015
Published on: 17 May, 2015
Page: [1165 - 1171]
Pages: 7
DOI: 10.2174/1389450116666150518101617
Price: $65

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