Three Considerations Before Advising 5-Alpha-Reductase Inhibitors for Chemoprevention

June 2009 in “ Journal of Clinical Oncology ”

Patrick C. Walsh

5-α-reductase inhibitors finasteride prostate-specific antigen PSA Prostate Cancer Prevention Trial PCPT 5-ARIs Propecia

TLDR 5-α-reductase inhibitors don't prevent prostate cancer but may reduce unnecessary biopsies.

The document discussed three key considerations regarding the use of 5-α-reductase inhibitors (5-ARIs) for prostate cancer chemoprevention. It highlighted that 5-ARIs did not prevent prostate cancer but reduced the likelihood of men undergoing diagnostic biopsies by lowering prostate-specific antigen (PSA) levels by at least 50%, potentially creating a false sense of security. In the Prostate Cancer Prevention Trial (PCPT), 25% fewer men on finasteride were diagnosed with prostate cancer, primarily because 15% fewer underwent biopsies. Among those who did have biopsies, the risk of a positive result was only reduced by 10%, with a non-significant 3% absolute difference compared to placebo. Therefore, finasteride did not significantly reduce cancer risk in men who were closely monitored and underwent biopsies due to elevated PSA or abnormal exams, which was the intended prevention setting.

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community Dutasteride is way more effective than Finasteride (Study)

in Research/Science 184 upvotes 10 months ago

Dutasteride is more effective than Finasteride for hair loss, with similar safety profiles. Individual responses vary, and factors like Minoxidil use and age differences may influence results.

community Hormonal panel after 1 year of treatment - DHT levels doubled!!

in Finasteride/Dutasteride 6 upvotes 2 years ago

A 27-year-old man shared his hormonal panel results after one year of taking finasteride 1mg/day for hair loss, showing his DHT levels nearly doubled. He reported stabilized hair loss with mild side effects that resolved, and he is considering a hair transplant but is concerned about the increased DHT levels and potential treatment options.

community FCE 28260: A Forgotten 5α-Reductase Inhibitor

nkrata in Research 330 upvotes 1 year ago

FCE 28260 (PNU 156765), an under-explored 5α-reductase inhibitor, showcases promising results in research by Giudici et al., outperforming well-known treatments like Finasteride in reducing the conversion of testosterone to DHT. Its superior efficacy, demonstrated through lower IC50 values in both natural and human recombinant enzyme studies, suggests it could offer more effective management of DHT-related conditions. Additionally, its lower molecular weight hints at better potential for topical application, potentially offering advantages in treating conditions such as androgenic alopecia. Despite its potential, it has not advanced in development, possibly due to financial limitations, leaving its therapeutic prospects and side effect profile largely unexplored.

community Topical Finasteride Doesn't Directly Reduce 5ar Enzyme on Scalp

in Finasteride/Dutasteride 72 upvotes 2 years ago

Topical Finasteride doesn't directly reduce 5ar enzyme on scalp and has the same mechanism as oral, needing to go through the liver. Users debate the accuracy of this information and discuss various studies and experiences.

community No fearmongering /just facts on yesterday someone posting on eye issues

in Finasteride/Dutasteride 33 upvotes 10 months ago

Finasteride and dutasteride may not significantly impact meibomian gland function since these glands do not rely on DHT. Some users report dry eyes and other side effects from finasteride, but these may be influenced by other factors or medications.

community EU Shouldn't Ban Fin & Dut: PFS is NOT REAL.

in Research/Science 11 upvotes 1 year ago

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