Department of Urology, School of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, South Korea; Chungbuk National University Hospital, Cheongju, South Korea.
Department of Dermatology, School of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, South Korea; Chungbuk National University Hospital, Cheongju, South Korea.
J Urol. 2017 Dec;198(6):1340-1345. doi: 10.1016/j.juro.2017.07.075. Epub 2017 Jul 23.
In this retrospective cohort study we assessed the effect on prostate specific antigen concentration of low dose finasteride or dutasteride treatment for male androgenetic alopecia in men with baseline serum prostate specific antigen less than 2.5 ng/ml.
The cohort consisted of 1,379 consecutive male patients who were treated for androgenetic alopecia with finasteride 1.25 mg daily or dutasteride 0.5 mg every 3 days in 2002 to 2012 and who underwent prostate specific antigen measurements at baseline and at least once thereafter. Patients in whom baseline or followup prostate specific antigen after prescription exceeded 2.5 ng/ml were excluded from study to rule out men with a higher likelihood of prostate cancer. Patients were stratified according to age, baseline prostate specific antigen, medication type and treatment duration.
Overall low dose 5α-reductase inhibitor treatment reduced prostate specific antigen by 27.8% relative to baseline. Of the patients 1,094 (79.3%) showed prostate specific antigen decreases (average 40.8%). In the remaining 285 patients (20.7%) prostate specific antigen was stable or increased (average 24.2% increase). Closer analysis largely showed that only men with baseline prostate specific antigen 0.5 ng/ml or greater had a treatment related prostate specific antigen reduction. On multivariate logistic analysis low baseline prostate specific antigen was significantly associated with stable/increased prostate specific antigen. Low dose dutasteride and finasteride reduced prostate specific antigen to similar degrees (31.1% and 25.1%, respectively). A marked prostate specific antigen decrease of 26.0% was observed even after short-term treatment (3 to 6 months).
Dutasteride and finasteride reduced prostate specific antigen to similar degrees. This effect was observed soon after commencing treatment. In patients with low baseline prostate specific antigen the levels could remain stable or even increase. These findings are limited to men with baseline prostate specific antigen less than 2.5 ng/ml.
在这项回顾性队列研究中，我们评估了低剂量非那雄胺或度他雄胺治疗基线前列腺特异性抗原（PSA）<2.5ng/ml 的男性雄激素性脱发对 PSA 浓度的影响。
该队列包括 2002 年至 2012 年期间因雄激素性脱发接受非那雄胺 1.25mg 每日或度他雄胺 0.5mg 每 3 天治疗的 1379 例连续男性患者，并在基线和此后至少一次进行 PSA 测量。排除基线或处方后随访 PSA 超过 2.5ng/ml 的患者，以排除前列腺癌可能性较高的男性。根据年龄、基线 PSA、药物类型和治疗持续时间对患者进行分层。
总体而言，低剂量 5α-还原酶抑制剂治疗使 PSA 相对于基线降低了 27.8%。在患者中，1094 例（79.3%）出现 PSA 下降（平均下降 40.8%）。在其余 285 例患者（20.7%）中，PSA 稳定或增加（平均增加 24.2%）。更详细的分析表明，只有基线 PSA 为 0.5ng/ml 或更高的男性才具有与治疗相关的 PSA 降低。多变量逻辑分析表明，低基线 PSA 与 PSA 稳定/增加显著相关。低剂量度他雄胺和非那雄胺降低 PSA 的程度相似（分别为 31.1%和 25.1%）。即使在短期治疗（3 至 6 个月）后，也观察到 PSA 显著下降 26.0%。
度他雄胺和非那雄胺降低 PSA 的程度相似。这种作用在开始治疗后不久就出现了。在基线 PSA 较低的患者中，PSA 水平可能保持稳定甚至增加。这些发现仅限于基线 PSA<2.5ng/ml 的男性。
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