5ARI and PSA: Open Questions

July 2014 in “ Urologia Journal ”

Andrea Tubaro, Federica Puccini, Cosimo De Nunzio

5-alpha reductase inhibitors finasteride dutasteride benign prostatic hyperplasia prostate specific antigen 5ARI Propecia Avodart PSA

TLDR 5ARI treatment improves PSA test accuracy for prostate cancer diagnosis.

The document discussed the challenges and limitations of using serum prostate specific antigen (PSA) as a diagnostic tool for prostate cancer, particularly in the context of benign prostatic hyperplasia (BPH) and other factors that can elevate PSA levels. It highlighted that 5-alpha reductase inhibitors (5ARI), such as finasteride and dutasteride, used to treat BPH, significantly reduced PSA levels by about 50%. This reduction raised concerns about the reliability of PSA testing for early prostate cancer diagnosis in patients undergoing 5ARI treatment. However, analysis of clinical trial data suggested that PSA testing accuracy was not only maintained but improved with 5ARI use, effectively resolving concerns about PSA accuracy during such treatment.

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