5alpha-reductase inhibitors in benign prostatic hyperplasia and prostate cancer risk reduction.
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.
Rittmaster
Roger S
RS
Urology Clinical Development and Medical Affairs, GlaxoSmithKline, Research Triangle Park, NC 27709, USA. roger.s.rittmaster@gsk.com
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
D058891:5-alpha Reductase Inhibitors; D000970:Antineoplastic Agents; D004791:Enzyme Inhibitors; D012739:Gonadal Steroid Hormones; D007527:Isoenzymes