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Abstract
Objectives
Finasteride is known to lower total serum prostate-specific antigen (PSA) levels by
approximately 50%. Terazosin is thought to have little or no effect on serum PSA concentration.
The objective of our study was to determine the effect of finasteride and terazosin
on serum total and serum free PSA levels and the ratio of free to total PSA.
Methods
We identified 69 men with symptomatic benign prostatic hyperplasia (BPH) who had been
receiving 5 mg/day (n = 33) of finasteride or 2 to 5 mg/day (n = 14) of terazosin
or no therapy (“watchful waiting”) (n = 22). The three groups were compared with respect
to pretreatment total serum PSA levels and post-treatment total, free, and percent
free serum PSA levels.
Results
Median (± semi-interquartile range [SIR]) pretreatment total serum PSA levels (ng/mL)
were not significantly different in men taking finasteride (2.8 ± 1.9), terazosin
(2.2 ± 2.5), or undergoing watchful waiting (5.5 ± 1.4) (p = 0.12). The median (± SIR) post-treatment total serum PSA levels (ng/mL) were significantly
lower in the finasteride group (1.1 ± 1) when compared with the terazosin (2.5 ± 1.5)
or watchful waiting (4.3 ± 2.8) groups (p = 0.016). Only the finasteride group had significantly lower post-treatment total
serum PSA levels compared with pretreatment levels. The median (± SIR) post-treatment
free PSA levels were significantly lower in the finasteride group (0.26 ± 0.16) compared
with the terazosin (0.54 ± 0.5) and watchful waiting (0.85 ± 0.5) groups (p = 0.0015). However, the median (± SIR) percent free PSA was not significantly different
in the finasteride (23 ± 6), terazosin (22 ± 4), and watchful waiting (25 ± 5) groups
(p = 0.66).
Conclusions
Finasteride appears to lower total and free PSA levels equally in men with BPH and
does not appear to change the ratio of free to total serum PSA. Terazosin does not
appear to alter total or free serum PSA levels in men with BPH. The percent free PSA
could potentially be used to screen for prostate cancer in men taking finasteride.
Prospective studies are needed to further evaluate this issue.
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References
- The effect of finasteride on prostate-specific antigen in men with benign prostatic hyperplasia.Prostate. 1993; 22: 31-37
- Treatment of benign prostatic hyperplasia with five alpha reductase inhibitors.Endocrinologist. 1995; 5: 140-146
- The effect of finasteride on prostate specific antigen: review of available data.J Urol. 1996; 155: 3-9
- Terazosin and finasteride both lower the serum prostate-specific antigen (PSA) level in men with benign prostatic hyperplasia (BPH).J Urol. 1996; 155: 424A
- Serum prostate-specific antigen complexed to α1-antichymotrypsin as an indicator of prostate cancer.J Urol. 1993; 150: 100-105
- Measurement of the proportion of free to total prostate-specific antigen improves diagnosis performance of prostate-specific antigen in the diagnostic gray zone of total prostate-specific antigen.Urology. 1995; 46: 187-194
- Evaluation of percentage of free serum prostate-specific antigen to improve specificity of prostate cancer screening.JAMA. 1995; 274: 1214-1220
- Effect of long term treatment with finasteride on free and total PSA in serum.J Urol. 1996; 155: 698A
- Serum concentrations of prostate specific antigen and its complex with α1-antichymotrypsin before diagnosis of prostate cancer.Lancet. 1994; 344: 1594-1598
- Stability of free prostate-specific antigen in serum samples under a variety of sample collection and sample storage conditions.Urology. 1996; 48 (suppl): 33-39
- Finasteride decreases free and total serum PSA concentration but does not significantly alter the percent free PSA value.J Urol. 1997; 157: 517A
- Serum PSA levels after 52 weeks of therapy with finasteride, terazosin, combination and placebo. Results of the VA Cooperative Study #359.J Urol. 1996; 155: 533A
Article info
Publication history
Accepted:
June 20,
1997
Received:
March 14,
1997
Footnotes
**This study was supported in part by a grant from Hybritech Inc., San Diego, California.
Identification
Copyright
© 1997 Elsevier Science Inc. all rights reserved. Published by Elsevier Inc.
