Clinical changes of withdrawal finasteride in patients with benign prostatic hyperplasia

Abstract

Objective To study changes in lower urinary tract symptoms, serum prostate-specific antigen, and prostate volume after discontinuation of finasteride combination therapy in patients with benign prostatic hyperplasia. Methods From December 2011 to June 2016, clinical data were collected retrospectively from 83 men more than 55 years of age with moderate to severe BPH symptoms (IPSS≥8). The men were classified into group A (n=43) and group B (n=40) according to the use of finasteride therapy. A combination of finasteride 5 mg with tamsulosin 0.2 mg was given daily to all patients for one year. For the next one year, group 1 received the combination therapy and group 2 received tamsulosin 0.2 mg monotherapy only. The IPSS, PSA level, and prostate volume were measured at baseline and at 12 and 24 months according to the use of dutasteride. Results Withdrawal of finasteride led to significant deterioration of LUTS, increased PSA level, and increased prostate volume. The repeated-measures analysis of variance showed that the changes in IPSS, PSA level, and prostate volume over time also differed significantly between groups A and B (P<0.001). Conclusions Discontinuation of finasteride during combination therapy results in prostate regrowth and deterioration of LUTS. The PSA level is also affected by the use of 5-alpha reductase inhibitors(5ARI). Therefore, regular check-up of the IPSS and PSA level may be helpful for all patients who either continue or discontinue the use of 5ARI. Key words: Prostatic Hyperplasia; Prostate-Specific Antigen