finasteride, Propecia
Evaluation of prostatic intraepithelial neoplasia after treatment with a 5-alpha-reductase inhibitor (finasteride). A methodologic approach.

Montironi R, Pomante R, Diamanti L, Hamilton PW, Thompson D, Bartels PH.

Institute of Pathological Anatomy and Histopathology, University of Ancona, Italy.

OBJECTIVE: To develop a methodology applicable to the morphologic study of the efficacy of finasteride on prostatic intraepithelial neoplasia (PIN), a putative precursor of prostate cancer. STUDY DESIGN: Three PIN foci were reviewed in two simple prostatectomy specimens from patients with clinical diagnoses of benign prostatic hyperplasia and treated with finasteride for six months. The feasibility of PIN diagnosis and grading based on "diagnostic distance" was investigated. It is a measure of the "extent" to which the observed features are different from those of the untreated prototypes representing the following diagnostic categories: normal prostate, low and high grade PIN and prostatic adenocarcinoma with a cribriform or large acinar pattern. Uncertainty in the PIN diagnosis and grading was dealt with by means of a Bayesian belief network (BBN). RESULTS: The distance measure values of the three PIN foci from the prototype of untreated, nonneoplastic prostate were 9, 7 and 8, respectively, in relative, arbitrary units. Their distance from the two prostate cancer patterns (large acinar and cribriform) was as high as 8-10. The distance of these foci from either low or high grade PIN were as low as 5, 3 and 2, and 3, 5 and 4, respectively. BBN produced the highest belief values for PIN, thus confirming the morphology-based and diagnostic distance-supported diagnosis; however, the belief values were low for both grades. CONCLUSION: The results provided by BBN analyses and diagnostic distance measures support the conclusion that this methodology is applicable to assessing the efficacy of finasteride treatment of PIN.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8978870&dopt=Abstract finasteride Propecia



finasteride, Propecia
The role of sex steroids in the pathogenesis and maintenance of benign prostatic hyperplasia.

Levine AC, Kirschenbaum A, Gabrilove JL.

Department of Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA.

BACKGROUND: It has long been suspected that sex steroids play a key role in the pathogenesis of benign prostatic hyperplasia (BPH). Prostatic diseases do not occur in males castrated before puberty or in males with heritable disorders of androgen production or action. Both estrogens and androgens have been shown to induce BPH in experimental animals. METHODS: Clinical studies utilizing hormonal therapies to treat BPH were reviewed. Studies that used total medical castration therapy via the use of a long-acting gonadotropin-releasing hormone (GnRH agonist), partial androgen blockade via the use of the 5 alpha-reductase inhibitor finasteride, and estrogen blockade (via the use of aromatase inhibitors) were analyzed. RESULTS AND CONCLUSIONS: Both the GnRH agonists and finasteride result in prostatic size reduction and alleviate symptoms in some patients. Both therapies are more effective in men with larger prostates (> 40 cc). Finasteride is less efficacious in terms of size reduction than the GnRH agonists but also has fewer side effects. To date, clinical trials with aromatase inhibitors have not yielded dramatic positive results in the treatment of BPH.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8997072&dopt=Abstract finasteride Propecia



finasteride, Propecia
The impact of different therapies on symptoms of benign prostatic hyperplasia: a prospective study.

Kawachi I, Barry MJ, Giovannucci E, Rimm EB, Colditz GA, Stampfer MJ, Willett WC.

Department of Health and Social Behavior, Harvard School of Public Health, Boston, Massachusetts, USA.

We conducted an observational study to evaluate prospectively the effectiveness of four modes of treatment for benign prostatic hyperplasia (BPH)-watchful waiting, alpha-blocker therapy, finasteride therapy, and surgery (transurethral prostatectomy). A total of 1459 men aged 48 to 84 years, who were diagnosed for the first time by physicians as having BPH in 1994 and who had not received treatment, participated in the study. During 1 year of follow-up, 1064 (72.9%) men remained on no treatment (watchful waiting), 156 (10.7%) were treated with finasteride, 198 (13.6%) were treated with an alpha-blocker, and 41 (2.8%) underwent prostatectomy. The American Urological Association (AUA) Symptom Index was administered to the cohort before the initiation of treatment in 1994, as well as 1 year later. Improvements in lower urinary tract symptoms, as measured by the AUA Symptom Index, were assessed using linear and logistic regression, adjusting for age and baseline. Men who underwent prostatectomy reported the biggest improvements in lower urinary tract symptoms, whether assessed by mean changes in symptom scores relative to no treatment (-5.44; 95% confidence interval [CI]-6.91 to -3.97) or by the odds of improving by 5 or more points on the AUA Symptom Index (odds ratio, 12.66; 95% CI, 5.93 to 27.0). Irrespective of the initial degree of symptom severity, prostate surgery resulted in larger improvements than those reported for either finasteride or alpha-blocker therapy. In this prospective, observational study, prostatic surgery was associated with statistically and clinically significant improvements in BPH symptoms.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9001828&dopt=Abstract finasteride Propecia



finasteride, Propecia
[Treatment of prostate adenoma with finasteride. Contribution of cases]

[Article in Italian]

Avogadro A, Secreto G, Gattoni F, Spadone M, Sacrini A, Blanc M.

Divisione di Urologia, Universita degli Studi-Milano, Ospedale S. Paolo, Milano.

During recent years more and more researchers and clinicians have become interested in HPB in order to identify a medical therapy instead of surgery. The aim of our study was to find the value of finasteride in HPB therapy. We wanted to know if finasteride was able to improve the symptomatology and blood tests of patients afflicted with HPB. Every patient was agreed with the course of action of the 1991 Paris Urology Congress. All patients were treated with finasteride 5 mg/die for one year and inspected by prostatic echography and blood tests. The results of our study are every interesting and are discussed in the article.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9005588&dopt=Abstract finasteride Propecia



finasteride, Propecia
Anti-androgenic effects of combination finasteride plus flutamide in patients with prostatic carcinoma.

Fleshner NE, Fair WR.

Department Of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.

OBJECTIVES: To determine the anti-androgenic effects and safety of the combination of finasteride and flutamide in men with prostate cancer. PATIENTS AND METHODS: Seventeen men with various stages of prostate cancer, all of whom were candidates for androgen deprivation therapy, were treated with finasteride plus flutamide and were followed for a mean of 13.6 months using measurements of serum prostate specific antigen (PSA), and an assessment of regression and side-effects. RESULTS: The initial median PSA level was 19.8 ng/mL: at 3, 6 and 12 months the median PSA had fallen to 1.2, 0.85 and 0.8 ng/mL, respectively. In four patients followed for 2 years, the anti-neoplastic effects were sustained. Patients with initially palpable disease had regression, as assessed by a digital rectal examination. Side-effects included gynaecomastia (five patients), mildly elevated hepatic transaminases (two) and diarrhoea (one). Most men maintained their previous sexual function. CONCLUSIONS: Early results suggest that the combination of finasteride and flutamide provides significant anti-androgenic therapy and maintains sexual function in most men. A further investigation with more patients and a longer follow-up is warranted.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9014718&dopt=Abstract finasteride Propecia



finasteride, Propecia
Determination of concentrations of sex steroids in blood plasma and semen of male dogs treated with delmadinone acetate or finasteride.

Lange K, Cordes EK, Hoppen HO, Gunzel-Apel AR.

Institute for Reproductive Medicine, School of Veterinary Medicine, Bunteweg 15, D-30559 Hannover, Germany.

The concentrations of testosterone, 5 alpha-dihydrotestosterone, oestradiol and oestrone were determined in peripheral blood plasma and semen of male dogs. In an experimental study, three Beagles were treated once with delmadinone acetate (1 mg kg-1 body weight, i.m.) and three were submitted to oral applications of finasteride (1 mg kg-1 body weight) once a day for 3 weeks. In a clinical study, 51 dogs of different breeds were divided into four groups according to the total number of spermatozoa in ejaculates (normospermia, slight oligozoospermia, severe oligozoospermia and azoospermia). The testosterone concentrations were significantly lower in sperm-rich ejaculate fractions and prostatic secretions compared with blood plasma (P < 0.05). The lowest concentration of testosterone was found in prostatic fluid. Concentrations of 5 alpha-dihydrotestosterone were similar in blood plasma and sperm-rich fractions, and significantly lower in prostatic secretions (P < 0.05). The concentrations of oestradiol and oestrone did not differ between blood plasma and either ejaculate fraction. Significantly higher 5 alpha-dihydrotestosterone concentrations and significantly lower concentrations of oestradiol and oestrone were found in prostatic secretions from azoospermic ejaculates compared with prostatic secretions of normospermic and oligozoospermic ejaculates. Delmadinone acetate and finasteride caused reversible suppression of the secretory activity of the prostate gland. The application of delmadinone acetate led to a temporary alteration of maturation of epididymal spermatozoa.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11787194&dopt=Abstract finasteride Propecia