Finasteride May Be a Better Choice for Lower Urinary Tract Symptoms

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SAN FRANCISCO—Finasteride and dutasteride are similarly effective for treating lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia in properly selected patients, but dutasteride is associated with significantly greater sexual side effects and breast complications, researchers reported.

A team led by Steven Kaplan, MD, of Weill Cornell Medical College in New York, studied 378 men treated with either finasteride (197 men) or dutasteride (211 men) for five years. Subjects had a mean age of 58.7 years.

At one and five years, the two groups experienced similar improvements in International Prostate Symptom Score, maximum flow rate, post-void residual volume, and PSA levels, regardless of baseline prostate volume.

However, the incidence of erectile dysfunction, ejaculatory dysfunction, and decreased libido resulting in withdrawal from therapy was significant higher in the dutasteride arm (5.1%, 2.4, and 2.7%, respectively) than in the finasteride arm (2.1%, 1.8%, and 1.4%), according to findings presented at the American Urological Association Annual Meeting.

Additionally, self-reported breast tenderness, enlargement, or both occurred significantly more frequently in the dutasteride group than in the finasteride recipients (3.5% vs. 1.2%).

These long-term findings suggest that finasteride may be a more optimal choice as primary therapy than dutasteride, the authors concluded.

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