Current Pharmacological Treatment for Male LUTS due to BPH: Dutasteride or Finasteride?

    September 2015 in “Current Drug Targets
    Luisella Pirozzi, Petros Sountoulides, Pietro Castellan, Fabrizio Presicce, Riccardo Lombardo, Marilena Romero, Cosimo De Nunzio, Andrea Tubaro, Luigi Schips, Luca Cindolo
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    TLDR Both dutasteride and finasteride improve urinary symptoms, but dutasteride may be better at reducing the risk of prostate surgery and sudden inability to urinate.
    The document from 7 years ago reviewed the effectiveness of two 5-alpha reductase inhibitors (5ARIs), finasteride and dutasteride, in treating lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). The drugs have different pharmacokinetic and pharmacodynamic properties, with dutasteride achieving greater suppression of dehydrotestosterone (>90% vs 70% for finasteride), theoretically suggesting greater efficacy. However, this was not clinically demonstrated due to scarce and heterogeneous literature. Both drugs resulted in similar symptom improvements, but dutasteride seemed to have a better profile in reducing the risk of prostate surgery and acute urinary retention (AUR). The document concluded that more studies were needed to better evaluate the clinical and pharmacoeconomic profile of the two 5ARIs.
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