Change in Prostate Specific Antigen Concentration in Men with Prostate Specific Antigen Less than 2.5 ng/ml Taking Low Dose Finasteride or Dutasteride for Male Androgenetic Alopecia
The cohort consisted of 1,379 consecutive male patients who were treated for androgenetic alopecia with finasteride 1.25 mg daily or dutasteride 0.5 mg every 3 days in 2002 to 2012 and who underwent prostate-specific antigen measurements at baseline and at least once thereafter. Patients in whom baseline or follow-up prostate-specific antigen after prescription exceeded 2.5 ng/ml were excluded from the study to rule out men with a higher likelihood of prostate cancer. Patients were stratified according to age, baseline prostate-specific antigen, medication type and treatment duration.
Overall low dose 5a-reductase inhibitor treatment reduced prostate-specific antigen by 27.8% relative to baseline. Of the patients 1,094 (79.3%) showed prostate-specific antigen decreases (average 40.8%). In the remaining 285 patients (20.7%) prostate-specific antigen was stable or increased (average 24.2% increase). Closer analysis largely showed that only men with baseline prostate-specific antigen of 0.5 ng/ml or greater had a treatment-related prostate specific antigen reduction. On multivariate logistic analysis low baseline, the prostate-specific antigen was significantly associated with stable/increased prostate specific antigen. Low dose dutasteride and finasteride reduced prostate-specific antigen to similar degrees (31.1% and 25.1%, respectively). A marked prostate specific antigen decrease of 26.0% was observed even after short-term treatment (3 to 6 months).
Dutasteride and finasteride reduced prostate-specific antigen to similar degrees. This effect was observed soon after commencing treatment. In patients with low baseline prostate-specific antigen, the levels could remain stable or even increase. These findings are limited to men with baseline prostate specific antigen less than 2.5 ng/ml.
Authors:
Ho Won Kang, Myeong Heon Chae, Su Hyun Park, Sung Pil Seo, Won Tae Kim, Yong-June Kim, Seok-Joong Yun, Sang-Cheol Lee, Tae Young Yoon and Wun-Jae Kim
From the Departments of Urology (HWK, SPS, WTK, YJK, SJY, SCL, WJK) and Dermatology (MHC, SHP, TYY), School of Medicine and Medical Research Institute, Chungbuk National University and Chungbuk National University Hospital (HWK, MHC, SHP, SPS, WTK, YJK, SJY, SCL, TYY, WJK), Cheongju, South Korea
J Urol. 2017 Dec;198(6):1340-1345. doi: 10.1016/j.juro.2017.07.075. Epub 2017 Jul 23.
Go Beyond the Abstract and Read a Commentary by Zhamshid Okhunov, MD, University of California Irvine