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EXPERT'S COMMENTS |
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| Year : 2006 | Volume
: 22
| Issue : 2 | Page : 134 |
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Expert comments
Anil Mandhani
Associate Professor of Urology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
Correspondence Address:
Anil Mandhani
Associate Professor of Urology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0970-1591.26568
How to cite this article:
Mandhani A. Expert comments. Indian J Urol 2006;22:134 |
Though Dutasteride has been demonstrated to be safe and effective, no published trial in a peer reviewed literature has shown clinicallysignificant differences between Dutasteride and finasteride.[1] Clinical trials, sponsored primarily by the pharmaceutical companies who are manufacturing this drug, have shown Dutasteride to be an effective treatment of BPH compared with placebo and to likely possess efficacy similar to that of finasteride.[1] 12 month study by Glaxo smith Kline protocol AR 140001 quoted by authors also has shown that Dutasteride compared with Finasteride produced numerically, but not statistically significant greater improvement in urinary flow rate and symptoms scores after 1 year of treatment.[2] Authors in present study have reported through another pharmaceutical sponsored trial, a better result with Dutasteride than Finasteride at 6 months. They have compared the efficacy, safety and tolerability of Dutasteride (group B) with Finasteride (group A) in a fixed dose combination with a uro-selective -blocker Tamsulosin in management of symptomatic BPH, associated with LUTS. Authors have found that combination of Tamsulosin with Dutasteride results in early symptomatic relief and low post void residue than seen with Tamsulosin and Finasteride combination.
Both the groups were followed up at the end of 2nd, 4th, 8th, 12th and 24th week for clinical assessment using IPSS and other parameters.
Both the groups showed significant improvement in IPSS score, average uroflow and reduction in post void residue at 12th and 24th week but 88% of patients in Group-B experienced improvement in symptom score, urine flow and overall well being as compared to 74% in Group-A at the end of this study. Contrary to this, authors have highlighted that group B had an early improvement (10-14 days) based on subjective findings on recall basis which could be because of placebo effect. Moreover when IPSS was measured at 2, 4, 8 weeks then authors might not have found the difference in improvement in IPSS in both the groups as far as an early or late improvement in symptoms is concerned because results were analyzed at 12 and 24 weeks. Therefore, this article though provides data on better efficacy of Dutasteride in comparison to Finasteride combined with Tamsulosin, significance of difference in time to improvement in symptoms should be construed with caution.
 References | |  |
| 1. | Dolder CR. Dutasteride: A dual 5-alpha reductase inhibitor for thetreatment of symptomatic benign Prostatic hyperplasia. Ann Pharmacother 2006;40:658-65.  [PUBMED] [FULLTEXT] |
| 2. | Andriole GL, Kirby R. Safety and tolerability of the dual 5-reductase inhibitor Dutasteride in the treatment of Benign Prostatic Hyperplasia. Eur Urol 2003;44:82-8. [PUBMED] [FULLTEXT] |
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