1378 CHARATERISTICS OF PATIENTS ON NON-DAILY AND DAILY DUTASTERIDE COMPARED TO PATIENTS CYTOREDUCTION NAIVE

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperlasia: Medical and Hormonal Therapy1 Apr 20131378 CHARATERISTICS OF PATIENTS ON NON-DAILY AND DAILY DUTASTERIDE COMPARED TO PATIENTS CYTOREDUCTION NAIVE Richard Memo, Michelle Sergi, Mark Memo, Robert Ricchiuti, Daniel Ricchiuti, and Vincent Ricchiuti Richard MemoRichard Memo Poland, OH More articles by this author , Michelle SergiMichelle Sergi Boardman, OH More articles by this author , Mark MemoMark Memo Boardman, OH More articles by this author , Robert RicchiutiRobert Ricchiuti Boardman, OH More articles by this author , Daniel RicchiutiDaniel Ricchiuti Boardman, OH More articles by this author , and Vincent RicchiutiVincent Ricchiuti Boardman, OH More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2732AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES A single dose of Dutasteride has a half life of five and a half weeks. What is the clinical outcome of non-daily usage compared to the FDA approved daily dosage and patients cytoreduction naive? METHODS Age, ethnicity, dosage of Dutasteride, PSA, compliance, biopsy interval rate, cancer rate, Gleason score, and cost were the selected parameters. The study is retrospective based on the billing code 55700 for prostatic biopsy. The study period was from January 1, 2009 to July 31, 2012. Initial prostatic biopsy was 2 to 18 years from the study end date with patients continuously followed from time of biopsy. 896 patient charts were reviewed, but only 364 met the inclusion criteria of no exposure to cytoreduction prior to prostatic biopsy, initial prostatic biopsy negative, and desire of treatment for lower urinary tract symptoms in which the patients self selected one of three treatment options. 532 patients were excluded because they had cytoreduction exposure prior to initial prostatic biopsy, under two years of evaluation, initial biopsy positive, inconsistant follow-up, non compliance, or switched to another therapy. RESULTS The non-daily treatment group had 125 patients of which 57 had once a week usage, while 68 had two or three times a week treatment. The daily group had 114 patients initially treated with Dutasteride, but 67 switched to Finasteride after one year due to cost reasons. The cytoreduction naive control group had 125 patients. The daily treatment group was older (avg. age= 74 years; p=0.001). There was no difference in the number of biopsies over time in the three groups. The biopsy interval rate was 94 months and 49 months for the non-daily and daily patients respectively. Decrease in PSA was greatest in the daily group (avg.=-3.4 ng/ml). Cancer incidence was 4.8% 11.4%, and 16.8% for the non-daily, daily, and no treatment groups respectively. Higher grade tumors in the daily and no treatment groups were not significant. Cost of daily treatment of Dutasteride is $1560 per year while once a week treatment is $206 per year. CONCLUSIONS Non-daily treatment was more cost effective. PSA is lowered most by daily usage. The average number of biopsies per group was not different in the study period. Biopsy interval in the non-daily group was twice as long as the daily group. Cancer incidence in the non-daily group surprisingly was at least half compared to daily and no cytoreduction groups. Although not statistically significant, higher grade tumors were seen in the daily and no treatment groups. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e563-e564 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Richard Memo Poland, OH More articles by this author Michelle Sergi Boardman, OH More articles by this author Mark Memo Boardman, OH More articles by this author Robert Ricchiuti Boardman, OH More articles by this author Daniel Ricchiuti Boardman, OH More articles by this author Vincent Ricchiuti Boardman, OH More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...