摘要
良性前列腺增生(BPH)是一种潜在的进行性疾病,通常与下尿路症状(LUTS)相关并可能导致如急性尿潴留及良性前列腺增生相关手术等并发症的发生。目前可以治疗BPH的下尿路症状的药物中,只有一类新药,5α还原酶抑制剂 (5ARIs),可以有效的减少疾病进展的风险。目前主要存在有两种5ARIs,包括非那雄胺和度他雄胺。这两种药物有这不同的药代学和药效学性质。度他雄胺对双氢睾酮有着更强的抑制作用(度他雄胺:>90%,非那雄胺>70%),因此,理论上度他雄胺对缓解泌尿系统症状的疗效更大。然而,这一假说尚未得到临床证实。也没有足够的相关文献和科学的证据来证明这一点。本研究为了评价度他雄胺和非那雄胺之间是否存在临床差异进行了头碰头比较试验。用任一药物进行治疗后症状改善的结果相同,然而,度他雄胺在降低前列腺手术风险及急性尿潴留(AUR)有着更好的效果。为了更好的评估两种5ARIs药物的临床和药物经济学的特性,深入研究是很有必要的。
关键词: 5-α还原酶抑制剂,良性前列腺增生,度他雄胺,非那雄胺,下尿路症状,综述。
Current Drug Targets
Title:Current Pharmacological Treatment for Male LUTS due to BPH: Dutasteride or Finasteride?
Volume: 16 Issue: 11
Author(s): Luisella Pirozzi, Petros Sountoulides, Pietro Castellan, Fabrizio Presicce, Riccardo Lombardo, Marilena Romero, Cosimo De Nunzio and Andrea Tubaro, Luigi Schips and Luca Cindolo
Affiliation:
关键词: 5-α还原酶抑制剂,良性前列腺增生,度他雄胺,非那雄胺,下尿路症状,综述。
摘要: Benign prostatic hyperplasia (BPH) is a potentially progressive disease which is commonly associated with bothersome lower urinary tract symptoms (LUTS) and might result in complications, such as acute urinary retention and BPH-related surgery. In the current medical therapy scenario for LUTS attributed to BPH, only one class of drugs, 5-α reductase inhibitors (5ARIs), has been found to be effective in reducing the risk of disease progression. The two 5ARIs that are currently available include finasteride and dutasteride. These two drugs have different pharmacokinetic and pharmacodynamic properties. Greater suppression of dehydrotestosterone is achieved by dutasteride (>90% dutasteride vs 70% finasteride) which theoretically should correlate with greater efficacy in alleviating urinary symptoms. Unfortunately, this hypothesis has not yet been clinically demonstrated. The pertinent literature is scarce and heterogeneous and produces low scientific levels of evidence. The present review article aims to evaluate the comparative head-to-head studies in order to evaluate if the hypothetical clinical differences between dutasteride and finasteride do exist. Pharmacological treatment with either drug results in similar symptom improvements; however dutasteride seems to have a better profile in reducing the risk of prostate surgery and acute urinary retention (AUR). More studies are necessary to better evaluate both the clinical and pharmacoeconomic profile of the two 5ARIs.
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Luisella Pirozzi, Petros Sountoulides, Pietro Castellan, Fabrizio Presicce, Riccardo Lombardo, Marilena Romero, Cosimo De Nunzio and Andrea Tubaro, Luigi Schips and Luca Cindolo , Current Pharmacological Treatment for Male LUTS due to BPH: Dutasteride or Finasteride?, Current Drug Targets 2015; 16 (11) . https://dx.doi.org/10.2174/1389450116666150518101617
DOI https://dx.doi.org/10.2174/1389450116666150518101617 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
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