Finasteride reduces the risk of incident clinical benign prostatic hyperplasia

J. Kellogg Parsons, Jeannette M. Schenk, Kathryn B. Arnold, Karen Messer, Cathee Till, Ian M. Thompson, Alan R. Kristal

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Background: Despite the high prevalence of clinical benign prostatic hyperplasia (BPH) among older men, there remains a notable absence of studies focused on BPH prevention. Objective: To determine if finasteride prevents incident clinical BPH in healthy older men. Design, setting, and participants: Data for this study are from the Prostate Cancer Prevention Trial. After excluding those with a history of BPH diagnosis or treatment, or an International Prostate Symptom Score (IPSS) ≥8 at study entry, 9253 men were available for analysis. Outcome measurements and statistical analysis: The primary outcome was incident clinical BPH, defined as the initiation of medical treatment, surgery, or sustained, clinically significant urinary symptoms (IPSS >14). Finasteride efficacy was estimated using Cox proportional regression models to generate hazards ratios (HRs). Results and limitations: Mean length of follow-up was 5.3 yr. The rate of clinical BPH was 19 per 1000 person-years in the placebo arm and 11 per 1000 person-years in the finasteride arm (p < 0.001). In a covariate-adjusted model, finasteride reduced the risk of incident clinical BPH by 40% (HR: 0.60; 95% confidence interval, 0.51-0.69; p < 0.001). The effect of finasteride on incident clinical BPH was attenuated in men with a body mass index ≥30 kg/m2 (pinteraction = 0.04) but otherwise did not differ significantly by physical activity, age, race, current diabetes, or current smoking. The post hoc nature of the analysis is a potential study limitation. Conclusions: Finasteride substantially reduces the risk of incident clinical BPH in healthy older men. These results should be considered in formulating recommendations for the use of finasteride to prevent prostate diseases in asymptomatic older men.

Original languageEnglish (US)
Pages (from-to)234-241
Number of pages8
JournalEuropean Urology
Volume62
Issue number2
DOIs
StatePublished - Aug 2012

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Finasteride
Prostatic Hyperplasia
Prostate
Asymptomatic Diseases
Prostatic Neoplasms
Body Mass Index
Smoking
Placebos
Confidence Intervals
Exercise

Keywords

  • 5α-reductase inhibitor
  • Finasteride
  • Prevention and control
  • Prostatic hyperplasia
  • Prostatic neoplasm

ASJC Scopus subject areas

  • Urology

Cite this

Parsons, J. K., Schenk, J. M., Arnold, K. B., Messer, K., Till, C., Thompson, I. M., & Kristal, A. R. (2012). Finasteride reduces the risk of incident clinical benign prostatic hyperplasia. European Urology, 62(2), 234-241. https://doi.org/10.1016/j.eururo.2012.03.007

Finasteride reduces the risk of incident clinical benign prostatic hyperplasia. / Parsons, J. Kellogg; Schenk, Jeannette M.; Arnold, Kathryn B.; Messer, Karen; Till, Cathee; Thompson, Ian M.; Kristal, Alan R.

In: European Urology, Vol. 62, No. 2, 08.2012, p. 234-241.

Research output: Contribution to journalArticle

Parsons, JK, Schenk, JM, Arnold, KB, Messer, K, Till, C, Thompson, IM & Kristal, AR 2012, 'Finasteride reduces the risk of incident clinical benign prostatic hyperplasia', European Urology, vol. 62, no. 2, pp. 234-241. https://doi.org/10.1016/j.eururo.2012.03.007
Parsons JK, Schenk JM, Arnold KB, Messer K, Till C, Thompson IM et al. Finasteride reduces the risk of incident clinical benign prostatic hyperplasia. European Urology. 2012 Aug;62(2):234-241. https://doi.org/10.1016/j.eururo.2012.03.007
Parsons, J. Kellogg ; Schenk, Jeannette M. ; Arnold, Kathryn B. ; Messer, Karen ; Till, Cathee ; Thompson, Ian M. ; Kristal, Alan R. / Finasteride reduces the risk of incident clinical benign prostatic hyperplasia. In: European Urology. 2012 ; Vol. 62, No. 2. pp. 234-241.
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