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Current Status of 5alpha-Reductase Inhibitors in Prostate Disease Management
Korean Journal of Urology ; : 213-219, 2013.
Article in English | WPRIM | ID: wpr-82587
ABSTRACT
The key enzyme in the androgen synthesis and androgen receptor pathways is 5alpha-reductase (5-AR), which occurs as three isoenzymes. Types I and II 5-ARs the most important clinically, and two different 5-AR inhibitors (5-ARIs), finasteride and dutasteride, have been developed. Several urology associations have recommended and upgraded the use of 5-ARIs for an enlarged prostate with lower urinary tract symptoms. In the Prostate Cancer Prevention Trial and the Reduction by Dutasteride of Prostate Cancer Events Trial, 5-ARIs reduced the incidence of low-grade prostate cancer. However, despite the documented reductions in the overall incidence of prostate cancer, 5-ARIs are at the center of a dispute. The American Society of Clinical Oncology (ASCO) and the American Urology Association (AUA) presented clinical guidelines for the use of 5-ARIs for chemoprevention of prostate cancer in 2008. However, ASCO/AUA has eliminated these from the main "Clinical Guidelines" in 2012, because the U.S. Food and Drug Administration denied a supplemental New Drug Application for the use of dutasteride for prostate cancer chemoprevention. The 5-ARIs can also be used to manage hemospermia and prostatic hematuria, and to prevent intraoperative bleeding, although there is insufficient evidence for a standard strategy. This review summarizes the current use of 5-ARIs for prostate disease, including benign prostate hyperplasia, prostate cancer, prostate-related bleeding, and hemospermia.
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Full text: Available Index: WPRIM (Western Pacific) Main subject: Prostate / Prostatic Hyperplasia / Prostatic Neoplasms / Azasteroids / United States Food and Drug Administration / Urology / Receptors, Androgen / Incidence / Finasteride / Chemoprevention Type of study: Practice guideline / Incidence study / Prognostic study Language: English Journal: Korean Journal of Urology Year: 2013 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Prostate / Prostatic Hyperplasia / Prostatic Neoplasms / Azasteroids / United States Food and Drug Administration / Urology / Receptors, Androgen / Incidence / Finasteride / Chemoprevention Type of study: Practice guideline / Incidence study / Prognostic study Language: English Journal: Korean Journal of Urology Year: 2013 Type: Article