title: 5alpha-reductase inhibitors in benign prostatic hyperplasia and prostate cancer risk reduction.
abstract: Androgens play an essential role in prostatic development and function, but are also involved in prostate disease pathogenesis. The primary prostatic androgen, dihydrotestosterone (DHT), is synthesized from testosterone by 5alpha-reductase types 1 and 2. Inhibition of the 5alpha-reductase isoenzymes therefore has potential therapeutic benefit in prostate disease. The two currently approved 5alpha-reductase inhibitors (5ARIs), finasteride and dutasteride, have demonstrated long-term efficacy and safety in the treatment of benign prostatic hyperplasia. Finasteride, a type-2 5ARI, has also been studied for its ability to reduce the incidence of biopsy-detectable prostate cancer in the Prostate Cancer Prevention Trial. Treatment with dutasteride, a dual 5ARI, has been shown to result in a greater degree and consistency of DHT suppression compared with finasteride. Two large-scale studies of dutasteride are currently investigating the role of near-maximal DHT suppression in the settings of prostate cancer risk reduction and expectant management of localized prostate cancer.
authors.affiliation: Urology Clinical Development and Medical Affairs, GlaxoSmithKline, Research Triangle Park, NC 27709, USA. roger.s.rittmaster@gsk.com
authors.forename: Roger S
authors.initials: RS
authors.lastname: Rittmaster
mesh_terms: D058891:5-alpha Reductase Inhibitors; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D004791:Enzyme Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D007527:Isoenzymes / Q000378:metabolism / Q000502:physiology; D008297:Male; D008954:Models, Biological; D011470:Prostatic Hyperplasia / Q000188:drug therapy / Q000473:pathology / Q000517:prevention & control*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000517:prevention & control*; D012307:Risk Factors
chemical_list: D058891:5-alpha Reductase Inhibitors; D000970:Antineoplastic Agents; D004791:Enzyme Inhibitors; D012739:Gonadal Steroid Hormones; D007527:Isoenzymes