Hypogonadal Men with BPH Benefit from Dutasteride

Dutasteride treatment significantly improves urinary symptoms and bone mineral density (BMD) in hypogonadal men with benign prostatic hyperplasia (BPH) and low baseline serum total and free testosterone levels, according to Japanese investigators.

In addition, the researchers found that men with relatively low serum total and free testosterone levels at baseline experienced the largest increase in these levels while on dutasteride.

Kazuyoshi Shigehara, MD, of Ishikawa Prefectural Central Hospital in Kanazawa City, and colleagues studied 76 men with BPH who were taking 0.5 mg dutasteride daily for 52 weeks. Patients experienced a significant mean 28.7% reduction in prostate volume and improvement in International Prostate Symptom Score (IPSS) from 15.7 to 13.5). Treatment also was associated with significant improvements in Overactive Bladder Symptom Score (OSBSS) from 5.3 to 4.5 and post-void residual volume (PVR) from 73 to 52 mL.

Results showed that 42 men (55%) had an increase of 20% or greater in total testosterone (group A), whereas the remaining 34 men (45%) had less than a 20% increased in total testosterone (group B).

Group A experienced a significant mean increase in free testosterone (from 5.62 at baseline to 8.23 ng/mL at 12 months) and BMD/young adult mean (YAM) ratio (from 105.4% to 106.5%) and significant mean declines in PVR (from 74 to 50 mL), IPSS (from 16.6 to 13.5), and OABSS (from 5.3 to 4.8), Dr. Shigehara's group reported online ahead of print in The Aging Male. The researchers observed a significant decrease in free testosterone in group B (from 6.83 to 5.85 ng/mL), as well as a significant decrease in PVR (from 66 to 53 mL), but no significant change BMD/YAM ratio, IPSS, and OABSS.

Dutasteride had no clinically significant affect on body mass index, muscle volume, or serum values of low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, or blood sugar in either group.

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