Effect of dutasteride on intraprostatic androgen levels in men with benign prostatic hyperplasia or prostate cancer
Effect of dutasteride on intraprostatic androgen levels in men with benign prostatic hyperplasia or prostate cancer
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DOI：
10.1016/j.urology.2008.06.032
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发表时间：
2008-10-01
期刊：
影响因子：
2.1
通讯作者：
Wurzel, Rafael
中科院分区：
文献类型：
--
作者：
Rittmaster, Roger;Hahn, Robert G.;Wurzel, Rafael
目的杜他雄胺通过抑制前列腺内双氢睾酮（DHT）发挥其对前列腺的有益作用。本分析的目的是在3个随机研究中评估批准剂量的度他雄胺（0.5 mg/d），给予2周至4个月对血清和前列腺内DHT和睾酮水平的影响。方法：在经尿道前列腺切除术（良性前列腺增生研究，n = 256）或根治性前列腺切除术（前列腺癌研究，n = 51）期间收集的良性前列腺组织中，测量前列腺内雄激素水平，这些前列腺组织在接受度他雄胺、安慰剂或单独手术治疗2周、1、3或4个月后进行。在治疗期间的同一时间点评估血清雄激素水平。将对照组的数据汇总为1个对照组。结果：与单独使用安慰剂/手术相比，在治疗2周和1、3、4个月后，度他雄胺分别降低了83%、90%、92%和93%的前列腺内DHT水平。杜他雄胺使血清DHT水平在2周时较基线降低84%，在1、2、3和4个月时降低约90%，而对照组则增加5.2%。杜他雄胺降低DHT水平的同时，血清和前列腺内睾酮水平也相应升高。然而，杜他雄胺组的前列腺内睾酮水平普遍低于对照组的前列腺内DHT水平。结论：我们的研究结果表明，在所有评估点上，杜他雄胺对良性前列腺增生或前列腺癌患者的血清和前列腺内DHT水平均具有近乎最大的抑制作用。
OBJECTIVES Dutasteride exerts its beneficial effects on the prostate through suppression of intraprostatic dihydrotestosterone (DHT). The aim of this analysis was to assess the effects of the approved dose of dutasteride (0.5 mg/d), given for 2 weeks to 4 months, on the serum and intraprostatic DHT and testosterone levels in 3 randomized studies.METHODS Intraprostatic androgen levels were measured in benign prostatic tissue collected during transurethral resection of the prostate (benign prostatic hyperplasia studies, n = 256) or radical prostatectomy (prostate cancer study, n = 51), performed after 2 weeks, or 1, 3, or 4 months of treatment with dutasteride or with placebo or surgery alone. The serum androgen levels were assessed at the same points during treatment. Data from the control groups were pooled to provide I comparison group.RESULTS Dutasteride reduced the intraprostatic DHT levels by 83%, 90%, 92%, and 93% after 2 weeks and 1, 3, and 4 months of treatment, respectively, compared with placebo/surgery alone. Dutasteride reduced the serum DHT levels from baseline by 84% at 2 weeks and by approximately 90% at 1, 2, 3, and 4 months compared with a 5.2% increase in the control group. The decrease in DHT levels with dutasteride was accompanied by a reciprocal increase in the serum and intraprostatic testosterone levels. However, the intraprostatic testosterone levels in the dutasteride groups generally remained lower than the intraprostatic DHT levels in the control group.CONCLUSIONS The results of our study have shown that dutasteride provides near-maximal suppression of both serum and intraprostatic DHT levels in men with benign prostatic hyperplasia or prostate cancer at all points assessed.