TREATMENT OF BENIGN PROSTATIC HYPERPLASIA WITH 5-ALPHA-REDUCTASE INHIBITORS

Benign prostatic hyperplasia (BPH) is a disease diagnosed by the presence of prostatic enlargement and lower tract urinary obstruction. Finasteride (Proscar(R)), is a potent and specific inhibitor of 5 alpha-reductase, that inhibits the conversion of testosterone (T) to dihydrotestosterone (DHT), an important promoter of prostatic growth. It has provided a new therapeutic alternative for the treatment of BPH. The safety and efficacy of finasteride in the treatment of symptomatic BPH have been demonstrated by two multicenter placebo controlled studies, After 12 months of treatment with finasteride 5 mg, prostate volume, DHT and prostate specific antigen (PSA) levels were reduced and maximum urinary flow rates and symptom scores were improved. Finasteride was well tolerated. Upon completion of the controlled studies patients were eligible to enter an open-label extension study in which all patients received finasteride 5 mg. Approximately half of the 543 patients randomized to the finasteride 5 mg group in the controlled studies have now been treated with finasteride 5 mg continuously for 3 years. The data provided by this group of patients on the long-term safety and efficacy of finasteride in the treatment of symptomatic BPH are reviewed.