Dutasteride May Ease Prostatitis-Related Symptoms

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SAN FRANCISCO—Dutasteride treatment may decrease prostatitis-related symptoms, data suggest.

The finding emerged from a study of men in the completed Reduction by Dutasteride of Prostate Cancer Events (REDUCE) trial, a four-year placebo-controlled study that examined the effect of dutasteride on prostate cancer risk. Chronic Prostatitis Symptom Index (CPSI) scores were available for 2,696 subjects in the dutasteride arm and 2,682 men in the placebo arm.

Of these subjects, 328 and 337, respectively, had prostatitis-like pain and 184 and 182, respectively, had prostatitis-like syndrome identified at baseline. At 48 months, the total CPSI score for prostatitis-like pain decreased by 5.35 points in the dutasteride arm compared with a 2.84 point decrease in the placebo recipients.

The total CPSI score for prostatitis-like syndrome decreased by 4.60 points in the dutasteride-treated men versus a 2.47 point decrease in the placebo arm. The differences between the groups were statistically significant.

The researchers, led by J. Curtis Nickel, MD, Professor of Urology at Queens University in Kingston, Ont., also looked at the proportion of subjects in each group who had a least a four-point or six-point decrease in total CPSI score (minimal response and moderate response, respectively).

Dr. Nickel's group observed significantly more responders (both four- and six-point CPSI responders) in the dutasteride-treated patients compared with placebo recipients. With respect to prostatitis-like pain and prostatitis-like syndrome among dutasteride-treated men, 63.3% and 58.6%, respectively, had a four-point response and 49.2% and 46.6% had a six-point response. The proportions for the placebo recipients were 49.8% and 45.4%, respectively, and 37.5% and 32.8%, respectively.

Effective therapy is not available for many men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), Dr. Nickel said, so it is reasonable to suggest that dutasteride therapy may be considered for “older” treatment refractory CP/CPPS patients with an organ specific (i.e., pain or discomfort associated with the prostate gland) or urinary (i.e., LUTS) clinical phenotype.

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