The Effect of Dutasteride on Serum Prostate-specific Antigen (PSA) in Patients with Benign Prostate Hypertrophy

ABSTRACT

PURPOSE: 5alpha reductase, dutasteride, has widely used to treat enlarged prostate (BPH). By suppressing the conversion of testosterone to dihydrotestosterone it decreases serum prostate-specific antigen (PSA) which is very important screening marker for prostate cancer. We evaluate the early serum PSA changes after dutasteride treatment to Korean BPH patients. MATERIALS AND METHODS: A total 159 men with a clinical diagnosis of BPH and no evidence of prostate cancer were enrolled. They were treated with dutasteride 0.5mg daily for 12 months. Serum PSA was evaluated at 2, 6, and 12 months after the medication. RESULT: Dutasteride statistically significantly reduced serum PSA to 0.70+/-0.52, 0.64+/-0.35, and 0.59+/-0.49 from baseline level at 2, 6, and 12 months after the medication, respectively. However, there was no statistical significance among the three groups in serum PSA changes after dutasteride. There were statistically significant correlations between a high pre-treatment serum PSA level and a large reduction of follow-up PSA levels at 2, 6, and 12 months after dutasteride treatment. CONCLUSIONS: The reduction of serum PSA is variable in patients to patients at 2, 6, and 12 months after dutasteride treatment. The patient with high initial serum PSA revealed a large reduction of serum PSA level after treatment. The traditional concept that follow-up serum PSA level should be doubled for prostate cancer screening may overestimate real serum PSA level within 12 months in Korean men receiving 5alpha reductase inhibitors.