TREATMENT OF BENIGN PROSTATIC HYPERPLASIA WITH 5-ALPHA-REDUCTASE INHIBITORS

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, that inhibits the conversion of testosterone (T) to dihydrote stosterone (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 finasteride 5 mg, prostate volume, DHT and prostate specific antigen (PSA) levels were reduced and maximum u rinary flow rates and symptom scores were improved. Finasteride was we ll tolerated. Upon completion of the controlled studies patients were eligible to enter an open-label extension study in which all patients received finasteride 5 mg. Approximately half of the 543 patients rand omized to the finasteride 5 mg group in the controlled studies have no w been treated with finasteride 5 mg continuously for 3 years. The dat a provided by this group of patients on the long-term safety and effic acy of finasteride in the treatment of symptomatic BPH are reviewed.