5-ALPHA-REDUCTASE INHIBITORS FINASTERIDE

Benign prostatic hyperplasia (BPH) is a disease diagnosed by the prese nce of prostatic enlargement and lower-tract urinary obstruction. Fina steride (Proscar(R)), is a potent and specific inhibitor of 5 alpha-re ductase, which inhibits the conversion of testosterone (T) to dihydrot estosterone (DHT) an important promoter of prostatic growth. It has pr ovided a new therapeutic alternative for the treatment of BPH. The saf ety and efficacy of finasteride in the treatment of symptomatic BPH ha ve been demonstrated by two multicenter placebo-controlled studies. Af ter 12 months of treatment with 5 mg finasteride daily, prostate volum e, DHT and prostate-specific antigen (PSA) levels were reduced and max imum urinary flow rates and symptom scores were improved. Finasteride was well-tolerated. Upon completion of the controlled studies, patient s were eligible to enter an open-label extension study in which all pa tients received 5 mg finasteride. Approximately half of the 543 patien ts randomized to the 5 mg finasteride group in the controlled studies have now been treated with 5 mg finasteride continuously for 3 years. The data provided by this group of patients on the long-term safety an d efficacy of finasteride in the treatment of symptomatic BPH are revi ewed. (C) 1996 Wiley-Liss, Inc.