Effects of 5α-reductase inhibitor therapy with dutasteride on bone metabolism in patients with benign prostatic hyperplasia

Objectives: The aim of this study was to investigate the effect of dutasteride on bone metabolism in patients with benign prostate hyperplasia (BPH). Design: Prospective study Setting: Sakarya University Sakarya Training and Research Hospital Subjects: Fifty patients were administered 0.5 mg dutasteride daily for treatment of BPH. Interventions: All patients were evaluated prior and six months after the treatment for bone metabolism. Main outcome measure: Standard parameters of bone metabolism and serum osteoprotogerin (OPG) levels, which is an important regulator for bone metabolism, were evaluated. Results: Seven of the 50 patients were lost to follow up and the remaining 43 patients were included in the study. Mean age of patients was 60.3 +/- 5.5 (range: 48-74) years. Dutasteride significantly increased serum testosterone and estradiol levels compared to pretreatment values. Mean OPG level increased from 198.3 +/- 40.5 pg/ml to 240 +/- 90.1 pg/ml (P=.019). Except T score of femur neck, there was an increase of T-Z scores in the lumbar spine and in the femur neck (P>.05). There was an increase in bone mineral density levels of the body, but only the increase in L4 vertebral value was statistically significant (P<.008). The treatment with dutasteride also caused significant decrease in prostate specific antigen levels and prostate volume as expected. Conclusions: It seems that, in addition to the benefits on prostatism symptoms, the short-term results of 5ARI on bone metabolism are promising.