Medical and Behavioral Variables Have More Impact on Physical Functioning Than Finasteride Treatment


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Taking finasteride over a 7-year period as part of the Prostate Cancer Prevention Trial (PCPT) “did not affect any of the three primary health-related quality-of-life domains—physical function, mental health, or vitality—either positively or negatively,” according to a study published in the Journal of the National Cancer Institute.1 Other medical and behavioral variables, particularly diabetes and smoking, had larger effects on physical function.

While finasteride was not associated with the physical functioning score at any of the study’s three time points—3 months prior to randomization, 6 months after randomization, and annually for 7 years—having diabetes at enrollment was associated with an 8.06 point decrease and being a smoker at enrollment was associated with a 5.53 point decrease in the physical functioning score at 6.5 years after randomization.

The PCPT was a double-blind, placebo-controlled trial that randomly assigned 18,882 men aged 55 years or older to receive the 5α-reductase inhibitor finasteride or placebo. “There was a 24.8% reduction in the prevalence of prostate cancer over the 7-year trial duration associated with finasteride treatment,” the authors noted. “In that initial report, finasteride was associated with increased sexual dysfunction; however, a subsequent publication demonstrated that the level of sexual dysfunction was minimal and decreased over time.”

Study Implications

The authors noted that finasteride is approved for the treatment of benign prostatic hyperplasia and that PCPT participants randomly assigned to finasteride reported a 40% to 44% reduction in incident, symptomatic benign prostatic hyperplasia compared with men who received placebo.

“These lower urinary tract symptoms have been associated with more falls in men. Benign prostatic hyperplasia symptoms are also associated with reduced health-related quality of life,” the authors stated. “These findings suggest that the use of finasteride to control benign prostatic hyperplasia symptoms may have health-related quality-of life benefits that were not measured in the PCPT. Taken together with the other findings discussed above, our results indicate that finasteride is a low-risk preventative agent with minimal impact on health-related quality of life.” ■

Reference

1. Moinpour CM, Darkea K, Donaldson GW, et al: Health-related quality-of-life findings for the Prostate Cancer Prevention Trial. J Natl Cancer Inst 104:1373-1385, 2012


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