NDLI: Effect of dutasteride on the risk of prostate cancer.

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Effect of dutasteride on the risk of prostate cancer.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Tammela, Teuvo L. Gomella, Leonard G. Pettaway, Curtis A. Teloken, Claudio Tindall, Donald J. Montorsi, Francesco Andriole, Gerald L. Bostwick, David G. Fowler, Ivy L. Rittmaster, Roger S. Brawley, Otis W. Wilson, Timothy H. Somerville, Matthew C. Marberger, Michael
Description	Author Affiliation: Andriole GL ( Division of Urology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110, USA. andrioleg@wustl.edu)
Abstract	BACKGROUND: We conducted a study to determine whether dutasteride reduces the risk of incident prostate cancer, as detected on biopsy, among men who are at increased risk for the disease. METHODS: In this 4-year, multicenter, randomized, double-blind, placebo-controlled, parallel-group study, we compared dutasteride, at a dose of 0.5 mg daily, with placebo. Men were eligible for inclusion in the study if they were 50 to 75 years of age, had a prostate-specific antigen (PSA) level of 2.5 to 10.0 ng per milliliter, and had had one negative prostate biopsy (6 to 12 cores) within 6 months before enrollment. Subjects underwent a 10-core transrectal ultrasound-guided biopsy at 2 and 4 years. RESULTS: Among 6729 men who underwent a biopsy or prostate surgery, cancer was detected in 659 of the 3305 men in the dutasteride group, as compared with 858 of the 3424 men in the placebo group, representing a relative risk reduction with dutasteride of 22.8% (95% confidence interval, 15.2 to 29.8) over the 4-year study period (P<0.001). Overall, in years 1 through 4, among the 6706 men who underwent a needle biopsy, there were 220 tumors with a Gleason score of 7 to 10 among 3299 men in the dutasteride group and 233 among 3407 men in the placebo group (P=0.81). During years 3 and 4, there were 12 tumors with a Gleason score of 8 to 10 in the dutasteride group, as compared with only 1 in the placebo group (P=0.003). Dutasteride therapy, as compared with placebo, resulted in a reduction in the rate of acute urinary retention (1.6% vs. 6.7%, a 77.3% relative reduction). The incidence of adverse events was similar to that in studies of dutasteride therapy for benign prostatic hyperplasia, except that in our study, as compared with previous studies, the relative incidence of the composite category of cardiac failure was higher in the dutasteride group than in the placebo group (0.7% [30 men] vs. 0.4% [16 men], P=0.03). CONCLUSIONS: Over the course of the 4-year study period, dutasteride reduced the risk of incident prostate cancer detected on biopsy and improved the outcomes related to benign prostatic hyperplasia. (ClinicalTrials.gov number, NCT00056407.)
ISSN	00284793
Issue Number	13
Volume Number	362
e-ISSN	15334406
Journal	New England Journal of Medicine
Language	English
Publisher	Massachusetts Medical Society (United States)
Publisher Date	2010-04-01
Publisher Place	United States
Access Restriction	Subscribed
Subject Keyword	5-alpha Reductase Inhibitors Azasteroids Therapeutic Use Enzyme Inhibitors Prostatic Hyperplasia Drug Therapy Prostatic Neoplasms Prevention & Control Aged Adverse Effects Biopsy Double-Blind Method Dutasteride Erectile Dysfunction Chemically Induced Heart Failure Humans Male Middle Aged Prostate Pathology Prostate-Specific Antigen Blood Genetics Protein Isoforms Risk Treatment Outcome Comparative Study Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't Medicine
Content Type	Text
Resource Type	Article
Subject	Medicine

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