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.
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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