Clinical Medicine Insights: Therapeutics

Dutasteride, a synthetic 4-azasteroid, is a selective and competitive inhibitor of both type 1 and type 2 5-alpha-reductase isoenzymes approved for the treatment of men with symptomatic benign prostatic hyperplasia (BPH) who have an enlarged prostate. It has been demonstrated to be effective as monotherapy, or in combination with the alpha-adrenergic antagonist (a-blocker), tamsulosin, in several randomized, double-blind, placebo controlled trials and their open-label extensions. Treatment with dutasteride is generally safe and well tolerated. Dutasteride has become established in the management of men with lower urinary tract symptoms (LUTS) and reduces the risk of acute urinary retention and surgery related to BPH. Dutasteride may also have a role as a chemopreventive agent in the future as emerging evidence demonstrates a reduced risk of prostate cancer with this agent.