Dutasteride, Avodart * for the prevention of prostate cancer
| Author : Pierre Allain
||Date : 2010-4-30
Dutasteride is an inhibitor of 5-alpha-reductase type 1 and 2, indicated for the treatment of symptoms of benign prostatic hypertrophy, see inhibitors of 5-alpha reductase.
A paper published in the NEJM on 1 April 2010 studied the influence of the intake of 0.5 mg of dutasteride daily, versus placebo, on the incidence of prostate cancer in men aged 50 to 75 years. Overall, over four years, dutasteride reduced the incidence of prostate cancer by about 20% while reducing the manifestations of benign prostatic hypertrophy. However, if cancer are differenciated according their severity with Gleason score, dutasteride did not reduce the incidence of cancers of moderate severity and increased the incidence of cancers of high severity (Gleason score between 8 and 10). Mortality from all causes was similar in the placebo and the dutasteride groups (no death being directly due to prostate cancer).
The authors of the article conclude that dutasteride has a protective effect against the incidence of prostate cancer but the author of an editorial accompanying the article is more than reluctant to the use of dutasteride in this indication: He believes that dutasteride only masks the development of major cancers and provides a false security by lowering the PSA level.