PCN4 Role of 5-Alpha-Reductase Inhibitors, Statins, Aspirin, Nsaids on the Development of Prostate Cancer in Benign Prostatic Hyperplasia Patients-a Population Based Study

Steroidal 5α-reductase is a system of NADPH dependent enzyme that catalyzes the irreversible conversion of Δ4–3-ketosteroid precursor (testosterone) to its corresponding 5α-reduced metabolite (dihydrotestosterone). Initial role of DHT was discovered through males pseudohermaphroditism, a genetic disorder with complete or partial 5α-reductase deficiency accompanied with features at critical juncture of fetal and postnatal development. However, excessive DHT production, has brought a revolution in revealing the etiology of complications like prostate cancer and benign prostatic hyperplasia. Over the last two decades, converging lines of evidences have highlighted the role of 5α-reductase inhibitors in the treatment of these androgen dependent disorders. Finasteride and Dutasteride, are the two clinically approved inhibitors available in the market, that helps in reducing the prostate volume by blocking the 5a-reductase enzyme.

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Risk of Incident Antidepressant-Treated Depression Associated with Use of 5α-Reductase Inhibitors Compared with Use of α-Blockers in Men with Benign Prostatic Hyperplasia: A Population-Based Study Using the Clinical Practice Research Datalink

Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy ◽

10.1002/phar.1925 ◽

2017 ◽

Vol 37 (5) ◽

pp. 517-527 ◽

Cited By ~ 1

Author(s):

Katrina Wilcox Hagberg ◽

Hozefa A. Divan ◽

J. Curtis Nickel ◽

Susan S. Jick

Keyword(s):

Clinical Practice ◽

Benign Prostatic Hyperplasia ◽

Population Based ◽

Prostatic Hyperplasia ◽

Practice Research ◽

Clinical Practice Research Datalink ◽

Population Based Study ◽

Reductase Inhibitors

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CYP17 polymorphisms in relation to risks of prostate cancer and benign prostatic hyperplasia: A population-based study in China

International Journal of Cancer ◽

10.1002/ijc.11378 ◽

2003 ◽

Vol 107 (2) ◽

pp. 271-275 ◽

Cited By ~ 35

Author(s):

M. Patricia Madigan ◽

Yu-Tang Gao ◽

Jie Deng ◽

Ruth M. Pfeiffer ◽

Bao-Li Chang ◽

...

Keyword(s):

Prostate Cancer ◽

Benign Prostatic Hyperplasia ◽

Population Based ◽

Prostatic Hyperplasia ◽

Population Based Study

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5-Alpha Reductase Inhibitors and the Risk of Prostate Cancer Mortality in Men Treated for Benign Prostatic Hyperplasia

Mayo Clinic Proceedings ◽

10.1016/j.mayocp.2016.07.023 ◽

2016 ◽

Vol 91 (12) ◽

pp. 1717-1726 ◽

Cited By ~ 6

Author(s):

Lauren P. Wallner ◽

Julia R. DiBello ◽

Bonnie H. Li ◽

Stephen K. Van Den Eeden ◽

Sheila Weinmann ◽

...

Keyword(s):

Prostate Cancer ◽

Benign Prostatic Hyperplasia ◽

Cancer Mortality ◽

Prostatic Hyperplasia ◽

Prostate Cancer Mortality ◽

Reductase Inhibitors ◽

5 Alpha Reductase Inhibitors

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MP04-02 5-ALPHA REDUCTASE INHIBITORS AND THE RISK OF PROSTATE CANCER MORTALITY IN MEN TREATED FOR BENIGN PROSTATIC HYPERPLASIA

The Journal of Urology ◽

10.1016/j.juro.2016.02.1937 ◽

2016 ◽

Vol 195 (4S) ◽

Author(s):

Lauren Wallner ◽

Julia DiBello ◽

Bonnie Li ◽

Stephen Van Den Eeden ◽

Sheila Weinmann ◽

...

Keyword(s):

Prostate Cancer ◽

Benign Prostatic Hyperplasia ◽

Cancer Mortality ◽

Prostatic Hyperplasia ◽

Prostate Cancer Mortality ◽

Reductase Inhibitors ◽

5 Alpha Reductase Inhibitors

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Symptomatic benign prostatic hyperplasia: the role of 5-alpha-reductase inhibitors in the prevention of acute urinary retention and surgical therapy

Italian Journal of Medicine ◽

10.4081/itjm.2012.57 ◽

2012 ◽

pp. 57-62

Author(s):

Norma Marigliano ◽

Domenico Galasso

Keyword(s):

Benign Prostatic Hyperplasia ◽

Urinary Retention ◽

Surgical Therapy ◽

Acute Urinary Retention ◽

Prostatic Hyperplasia ◽

Complete Suppression ◽

Urinary Flow ◽

Reductase Inhibitors ◽

5 Alpha Reductase Inhibitors

Benign prostatic hyperplasia (BPH) is a disease that affects over 50% of males aged 50 years or older. In men aged >80 years, the incidence is 90%. BPH occurs in 9-25% of males aged 40 to 79 years. Fifty percent of patients with BPH are symptomatic. The symptoms include reduced urinary flow, nocturia, defective bladder emptying, urinary hesitancy, and dysuria. Disease progression can be associated with acute urinary retention (AUR). Prostatic obstruction includes mechanical and dynamic components, the latter mediated by alpha-muscarinic receptors. Treatment with alpha-1-blockers (alfuzosin, doxazosin, tamsulosin, and terazosin) leads to rapid amelioration of symptoms and urinary flow, usually within one or two weeks. The 5-alpha reductase inhibitors (5-ARIs) are “disease-modifying drugs.” They control the growth of the prostate by blocking the conversion of testosterone into dihydrotestosterone (DHT). Finasteride is a 5–ARI that is selective for type 2 receptors. Dutasteride is a powerful inhibitor of both 5- alpha reductase isoforms (type 1 and 2) and produces more complete suppression of DHT synthesis than finasteride. Dutasteride also has a much longer half-life than finasteride (five weeks versus five to six hours). The authors review the results of clinical trials involving finasteride and dutasteride, with and without alpha-1-blockers, highlighting the important role of dutasteride in improving acute urinary retention and eliminating the need for surgical therapy.

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Sexual Dysfunctions Related to Drugs Used in the Management of Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: A Narrative Review on α-Blockers and 5-Alpha Reductase Inhibitors

Uro ◽

10.3390/uro1030012 ◽

2021 ◽

Vol 1 (3) ◽

pp. 82-98

Author(s):

Antonio La Torre ◽

Caterina Palleria ◽

Irene Tamanini ◽

Andrea Scardigli ◽

Tommaso Cai ◽

...

Keyword(s):

Urinary Tract ◽

Benign Prostatic Hyperplasia ◽

Sexual Dysfunction ◽

Lower Urinary Tract ◽

Prostatic Hyperplasia ◽

Sexual Dysfunctions ◽

Reductase Inhibitors ◽

Urinary Tract Symptoms ◽

5 Alpha Reductase Inhibitors ◽

Lower Urinary

This is a critical review of the current literature data about sexual dysfunction as a potential side effect related to drugs commonly used for the treatment of Benign Prostatic Hyperplasia and Lower Urinary Tract Symptoms. In this narrative review, we analyzed data from the literature related to the development of sexual dysfunctions during the treatment of BPH or LUTS. Both α-blockers and 5-alpha reductase inhibitors (5-ARIs) can induce erectile dysfunction, ejaculatory disorders and a reduction in sexual desire. The sexual side effect profile of these drugs is different. Among the α-blockers, silodosin appears to have the highest incidence of ejaculatory disorders. Persistent sexual side effects after the discontinuation of finasteride have been recently reported; however, further studies are needed to clarify the true incidence and the significance of this finding. However, most of the published studies are affected by a weak methodology and other important limitations, with only a few RCTs available. Therefore, it is desirable that future studies will include validated tools to assess and diagnose the sexual dysfunction induced by these medications, especially for ejaculation and sexual desire disorders.

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Impact of cyclin D1 and DJ-1 on diagnosis, clinico-pathological features and outcome in prostate cancer and benign prostatic hyperplasia

Forum of Clinical Oncology ◽

10.2478/fco-2019-0005 ◽

2020 ◽

Vol 10 (2) ◽

pp. 15-25

Author(s):

Amrallah A. Mohammed ◽

Hanna M. Ibrahim ◽

Hanna A. Atwa ◽

Ayman Elshentenawy ◽

Amira Elwan

Keyword(s):

Prostate Cancer ◽

Benign Prostatic Hyperplasia ◽

Cyclin D1 ◽

Tumor Stage ◽

Prostatic Hyperplasia ◽

Common Finding ◽

Tissue Sampling ◽

Benign Lesions ◽

Significant Difference

AbstractBackgroundDisturbance in cell cycle regulatory genes is a common finding among many types of cancers. The aim of this study is to evaluate the role of cyclin D1 and DJ-1 in benign prostatic hyperplasia (BPH) and prostate cancer (PC).MethodThe current study enclosed 40 patients diagnosed with PC and 40 cases of BPH. The expression level of cyclin D1 and DJ-1 were evaluated by immunohistochemistry (IHC). Cyclin D1 scored depending on the percentage of stained nuclear tumor cells. While scoring of DJ-1 was based on intensity. The results were correlated with clinicopathological features and outcome.ResultsIn the PC group, cyclin D1 was detected in 95% and overexpressed in 42.5%, DJ-1 was positively stained in 85% and overexpressed in 47.5%. Meanwhile, in the BPH group, cyclin D1 was not detected and DJ-1 stained in only 2.5%. There was a statistically significant difference in Gleason score (GS), tumor stage, size, and treatment failure (p =< 0.001). In the terms of PC diagnosis prediction, although cyclin D1 was more specific (100%), DJ-1 is more sensitive than cyclin D1 (80%, 70%, respectively) (p = 0.000).ConclusionsCyclin D1 and DJ-1 may emerge as a promising way for diagnosis of PC in certain circumstances, as the presence of insufficient tissue sampling, small foci of carcinoma or benign lesions mimic PC. This is in addition to the known role of cyclin D1 and DJ-1 in PC prognosis.

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