PMID- 24064231
OWN - NLM
STAT- MEDLINE
DCOM- 20161114
LR  - 20161230
IS  - 0929-6646 (Print)
IS  - 0929-6646 (Linking)
VI  - 114
IP  - 9
DP  - 2015 Sep
TI  - 5alpha-Reductase inhibitor is less effective in men with small prostate volume and 
      low serum prostatic specific antigen level.
PG  - 865-71
LID - S0929-6646(13)00291-X [pii]
LID - 10.1016/j.jfma.2013.08.006 [doi]
AB  - BACKGROUND/PURPOSE: Large total prostate volumes (TPVs) or high serum 
      prostate-specific antigen (PSA) levels indicate high-risk clinical progression of 
      benign prostatic hyperplasia. This prospective study investigated the treatment 
      outcome of combined 5alpha-reductase inhibitor and alpha-blocker in patients with and 
      without large TPVs or high PSA levels. METHODS: Men aged >/= 45 years with 
      International Prostate Symptom scores (IPSS) >/= 8, TPV >/= 20 mL, and maximum flow 
      rate </= 15 mL/s received a combination therapy (dutasteride plus doxaben) for 2 
      years. Patients with baseline PSA >/= 4 ng/mL underwent prostatic biopsy for 
      excluding malignancy. The changes in the parameters from baseline to 24 months 
      after combination therapy were compared in those with and without TPV >/= 40 mL or 
      PSA levels >/= 1.5 ng/mL. RESULTS: A total of 285 patients (mean age 72 +/- 9 years) 
      completed the study. Combination therapy resulted in significant continuous 
      improvement in IPSS, quality of life index, maximum flow rate, and postvoid 
      residual (all p < 0.0001) regardless of baseline TPV or PSA levels. However, only 
      patients with baseline TPV >/= 40 mL had significant improvements in IPSS-storage 
      subscore, voided volume, reduction in TPV, transitional zone index, and PSA 
      levels. In addition, patients with baseline TPV < 40 mL and PSA < 1.5 ng/mL had 
      neither a reduction in TPV nor a decrease in serum PSA level. CONCLUSION: A high 
      TPV indicates more outlet resistance, whereas elevated serum PSA level reflects 
      glandular proliferation. Thus, patients with TPV<40 mL and low PSA levels has 
      less benefit from 5alpha-reductase inhibitor therapy. The therapeutic effect of 
      combined treatment may arise mainly from the alpha-blocker in these patients.
CI  - Copyright (c) 2013. Published by Elsevier B.V.
FAU - Lin, Victor C
AU  - Lin VC
AD  - Department of Urology, E-Da Hospital, Kaohsiung, Taiwan; Department of Healthcare 
      Administration, I-Shou University, Kaohsiung, Taiwan.
FAU - Liao, Chun-Hou
AU  - Liao CH
AD  - Department of Urology, Cardinal Tien Hospital, and School of Medicine, Fu-Jen 
      Catholic University, Taipei, Taiwan.
FAU - Wang, Chung-Cheng
AU  - Wang CC
AD  - Department of Urology, En Chu Kong Hospital, College of Medicine, National Taiwan 
      University, Taipei, Taiwan.
FAU - Kuo, Hann-Chorng
AU  - Kuo HC
AD  - Department of Urology, Buddhist Tzu Chi General Hospital, and Tzu Chi University, 
      Hualien, Taiwan. Electronic address: hck@tzuchi.com.tw.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
DEP - 20130921
PL  - Singapore
TA  - J Formos Med Assoc
JT  - Journal of the Formosan Medical Association = Taiwan yi zhi
JID - 9214933
RN  - 0 (5-alpha Reductase Inhibitors)
RN  - 0 (Adrenergic alpha-Antagonists)
RN  - EC 3.4.21.77 (Prostate-Specific Antigen)
RN  - NW1291F1W8 (Doxazosin)
RN  - O0J6XJN02I (Dutasteride)
SB  - IM
MH  - 5-alpha Reductase Inhibitors/*administration & dosage
MH  - Adrenergic alpha-Antagonists/*administration & dosage
MH  - Aged
MH  - Aged, 80 and over
MH  - Biopsy
MH  - Chi-Square Distribution
MH  - Disease Progression
MH  - Doxazosin/*administration & dosage
MH  - Drug Therapy, Combination
MH  - Dutasteride/*administration & dosage
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Prostate/pathology
MH  - Prostate-Specific Antigen/*blood
MH  - Prostatic Hyperplasia/*drug therapy/pathology
MH  - Quality of Life
MH  - Taiwan
MH  - Treatment Outcome
OTO - NOTNLM
OT  - 5alpha-reductase inhibitor
OT  - benign prostatic hyperplasia
OT  - prostatic specific antigen
OT  - total prostatic volume
EDAT- 2013/09/26 06:00
MHDA- 2016/11/15 06:00
CRDT- 2013/09/26 06:00
PHST- 2013/06/24 00:00 [received]
PHST- 2013/08/16 00:00 [revised]
PHST- 2013/08/20 00:00 [accepted]
PHST- 2013/09/26 06:00 [entrez]
PHST- 2013/09/26 06:00 [pubmed]
PHST- 2016/11/15 06:00 [medline]
AID - S0929-6646(13)00291-X [pii]
AID - 10.1016/j.jfma.2013.08.006 [doi]
PST - ppublish
SO  - J Formos Med Assoc. 2015 Sep;114(9):865-71. doi: 10.1016/j.jfma.2013.08.006. Epub 
      2013 Sep 21.