Long-Term Effectiveness of Finasteride for Benign Prostatic Hyperplasia

In a 4-year study involving 3,040 men with symptomatic benign prostatic hyperplasia (BPH), finasteride significantly reduced the incidence of acute urinary retention or BPH-related surgery compared to a placebo (6.6% vs. 13.2%). A subsequent 2-year open-label extension showed that when all participants received finasteride, the rate of these events dropped to about 1% per year. Over 6 years, the cumulative rate was 8% for the original finasteride group and 15% for the original placebo group. The study concluded that finasteride effectively prevented acute urinary retention and the need for surgery over the long term, with side effects remaining uncommon. Treating 14 men with finasteride could prevent 1 from reaching the clinical endpoint within 6 years, making it potentially cost-effective despite its high cost.