Dutasteride vs finasteride: assessment of differences in acute urinary retention rates and surgical risk outcomes in an elderly population aged > or =65 years.
OBJECTIVE
To determine comparative differences on rates of acute urinary retention (AUR) and prostate-related surgeries among patients aged > or =65 years treated with dutasteride or finasteride.


METHODS
For this retrospective analysis, medical/pharmacy claims data from July 1, 2003, to June 30, 2006, were analyzed for enlarged prostate patients aged > or =65 years treated with 5-alpha reductase inhibitors (5ARIs) regardless of alpha-blocker use. Charlson Comorbidity Index, Thomson Medstat Disease Staging, and propensity score matching techniques were used for comparative analysis.


RESULTS
A total of 5090 patients met selection criteria. After 1 year of 5ARI therapy, the AUR rate was lower for dutasteride (12%) when compared with finasteride (14.7%) (odds ratio [OR], 0.79; P = .0042). Risks for prostate-related surgeries were also lower among dutasteride-treated patients (3.9% vs 5.1%, respectively; OR, 0.77; P = .03).


CONCLUSIONS
Important therapeutic outcome differences exist between dutasteride and finasteride. Patients treated with dutasteride were significantly less likely to experience AUR and prostate-related surgeries than finasteride patients.
Fenter
Thomas C
TC
University of Mississippi, Corporate Medical Advisor Blue Cross & Blue Shield of Mississippi, Jackson, MS, USA. dtcfms@aol.com
Davis
E Anne
EA
Shah
Manan B
MB
Lin
Pei-Jung
PJ
D058891:5-alpha Reductase Inhibitors; D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001378:Azasteroids / Q000191:economics / Q000627:therapeutic use*; D000068538:Dutasteride; D004791:Enzyme Inhibitors / Q000191:economics / Q000627:therapeutic use*; D018120:Finasteride / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011468:Prostatectomy; D011470:Prostatic Hyperplasia / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D016055:Urinary Retention / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control / Q000601:surgery
D058891:5-alpha Reductase Inhibitors; D001378:Azasteroids; D004791:Enzyme Inhibitors; D018120:Finasteride; D000068538:Dutasteride