title: The effect of dutasteride on the detection of prostate cancer: A set of meta-analyses.
abstract: BACKGROUND
  Dutasteride has been shown to significantly improve symptoms of benign prostatic hyperplasia (BPH) and reduce clinical progression. Recent data from studies evaluating 5-alpha reductase inhibitors (5-ARIs) for the prevention of prostate cancer, however, suggest 5ARIs, including dutasteride, may be associated with increased incidence of Gleason 8-10 prostate tumours. This meta-analysis was undertaken to quantify the effect of dutasteride on detection of prostate cancer and high-grade prostate cancer.
  
  
  METHODS
  Our meta-analysis includes data from GlaxoSmithKline-sponsored phase III randomized clinical trials (with a study duration of ≥2 years) evaluating the effect of dutasteride, alone or in combination with tamsulosin, to treat BPH or to reduce the risk of prostate cancer. The incidence of prostate cancer, including Gleason 7-10 and Gleason 8-10, for patients taking either dutasteride, dutasteride plus tamsulosin, tamsulosin alone, or placebo, were evaluated using the Mantel-Haenszel Risk Ratio (MHRR) method of conducting meta-analyses.
  
  
  RESULTS
  The meta-analysis demonstrated that in a population with symptomatic BPH and/or at increased risk of prostate cancer, a statistically significant lower number of detectable prostate cancers was found in men taking dutasteride compared to control groups (MHRR: 0.66, 95% CI 0.52-0.85). In our analysis, there was no increased risk for Gleason 7-10 (MHRR: 0.83, 95% CI 0.56-1.21) or Gleason 8-10 prostate cancers (MHRR: 0.99, 95% CI 0.39-2.53) in men taking dutasteride over control groups. There were several limitations that need to be considered when interpreting these results.
  
  
  CONCLUSIONS
  These data provide support for the continued use of dutasteride in the treatment of symptomatic BPH patients.
authors.affiliation: Medical Affairs, GlaxoSmithKline Canada, Mississauga, ON;
authors.forename: Neerav
authors.initials: N
authors.lastname: Monga
authors.forename: Amyn
authors.initials: A
authors.lastname: Sayani
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Rubinger
authors.forename: Timothy H
authors.initials: TH
authors.lastname: Wilson
authors.forename: Zhen
authors.initials: Z
authors.lastname: Su