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Comparison of Finasteride and Dutasteride on Risk of Prostate Cancer in Patients with Benign Prostatic Hyperplasia: A Pooled Analysis of 15 Real-world Databasesopen access

Authors
Yang, Dae YulSeo, Won-WooPark, Rae WoongRhee, Sang YoulCha, Jae MyungHah, Yoon SooJeong, Chang WonKim, Kyung-JinYang, Hyeon-JongKim, Do KyungHa, Ji Yong
Issue Date
May-2024
Publisher
KOREAN SOC SEXUAL MEDICINE & ANDROLOGY
Keywords
Dutasteride; Finasteride; Prostatic hyperplasia; Prostatic neoplasms
Citation
WORLD JOURNAL OF MENS HEALTH
Journal Title
WORLD JOURNAL OF MENS HEALTH
URI
https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/26334
DOI
10.5534/wjmh.230327
ISSN
2287-4208
2287-4690
Abstract
Purpose: Finasteride and dutasteride are used to treat benign prostatic hyperplasia (BPH) and reduce the risk of developing prostate cancer. Finasteride blocks only the type 2 form of 5-alpha-reductase, whereas dutasteride blocks both type 1 and 2 forms of the enzyme. Previous studies suggest the possibility that dutasteride may be superior to finasteride in preventing prostate cancer. We directly compared the effects of finasteride and dutasteride on the risk of prostate cancer in patients with BPH using a pooled analysis of 15 real-world databases. Materials and Methods: We conducted a multicenter, cohort study of new-users of finasteride and dutasteride. We include patients who were prescribed 5 mg finasteride or dutasteride for the first time to treat BPH and had at least 180 days of prescription. We excluded patients with a history of prostate cancer or a prostate-specific antigen level >= 4 ng/mL before the study drug prescription. Cox regression analysis was performed to examine the hazard ratio (HR) for prostate cancer after propensity score (PS) matching. Results: A total of 8,284 patients of new-users of finasteride and 8,670 patients of new-users of dutasteride were included across the 15 databases. In the overall population, compared to dutasteride, finasteride was associated with a lower risk of prostate cancer in both on-treatment and intent-to-treat time-at-risk periods. After 1:1 PS matching, 4,897 patients using finasteride and 4,897 patients using dutasteride were enrolled in the present study. No significant differences were observed for risk of prostate cancer between finasteride and dutasteride both on-treatment (HR=0.66, 95% confidence interval [CI]: 0.44-1.00; p=0.051) and intent-to-treat time-at-risk periods (HR=0.87, 95% CI: 0.67-1.14; p=0.310). Conclusions: Using real-world databases, the present study demonstrated that dutasteride was not associated with a lower risk of prostate cancer than finasteride in patients with BPH.
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College of Medicine (Department of Pediatrics)
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