Finasteride monotherapy maintains stable lower urinary tract symptoms in men with benign prostatic hyperplasia following cessation of alpha blockers

Objective: Our Canadian multicentre open-label study sought to evaluate, inpatients with moderate/severe lower urinary symptoms (LUTS) secondary tobenign prostatic hyperplasia, the effect on symptoms of 9 months of monotherapywith finasteride 5 mg following 9 months of combination treatment (finasteridewith an α-blocker) as quantified according to the International ProstateSymptom Score (IPSS).Methods: The primary outcome measure for efficacy was the maintenance ofIPSS response after cessation of the α-blocker. Subjects were treated with acombination of finasteride and an α-blocker for 9 months and then with finasteridealone for 3 or 9 months.Results: Results showed that the IPSS scores after 3 months of monotherapy werewithin the criteria for equivalence to those after 9 months of combination therapy.Symptom control equivalence was also found after 9 months of monotherapy.The IPSS response rate was also similar for combination and monotherapy.The safety profile was similar and as expected with these medications.Conclusion: Control of LUTS associated with BPH thus appears to be maintainedfor at least 9 months with finasteride alone, following a 9-month course of combinationtherapy with finasteride and an α-blocker, with similar safety profiles.