Long-term use of 5-ARIs in low-risk men on AS

Perhaps unsurprisingly, your sitemaster was a little distracted on March 9 this year (by both the start of the COVID-19 chaos and by his birthday) and so he utterly missed what appears to be a rather important paper on the use of 5α-reductase inhibitors (5-ARIs) in men on active surveillance (AS) for management of low-risk forms of prostate cancer.

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BPH, 5-ARIs, PSA, and risk for prostate cancer diagnosis

It will come as no surprise to the well-informed that if you are taking a 5-alpha-reductase inhibitor (a 5-ARI) like dutasteride or finasteride for benign prostatic hyperplasia (BPH), it significantly lowers your “normal” PSA level (to about half the actual value). … READ MORE …

TARP trial shows limited benefits from 5-ARI + an anti-androgen in CRPC

For some 15+ years there have been subsets of patients and physicians who have believed strongly that adding a 5α-reductase inhibitor (5-ARI) like finasteride or dutasteride to an anti-androgen would quite certainly aid in the prevention of prostate cancer progression because such a regimen would reduce levels of dihydrotestosterone. … READ MORE …

New data on 5-ARI treatment in prevention of and and risk for prostate cancer

A new article in the journal JAMA Oncology has again suggested that the use of 5α-reductase inhibitors (5-ARIs) like finasteride/Proscar and dutasteride/Avodart is not, in fact, associated with any significant risk for clinically significant prostate cancer let alone risk for prostate cancer-specific mortality. … READ MORE …

5-ARIs and risk for high-grade prostate cancer: yet another data set

The question of whether the use of 5α-reductase inhibitors (5-ARIs) like finasteride (Proscar) and dutasteride (Avodart) is really associated with a significantly increased risk for diagnosis of high-risk and/or lethal prostate cancers remains unanswered. However, yet another set of data from the Health Professionals Follow-up Study (HPFS) has offered us some additional insights. … READ MORE …

5-ARIs and prostate cancer risk: one step forward; one step back

As is so often the case in medicine, data suggesting a positive finding from one study comes out at about the same time as data demonstrating exactly the opposite … and in prostate cancer this occurs all too frequently! … READ MORE …

Still “no sufficient evidence” to support any widespread prostate cancer prevention strategy

A new review of the available literature has concluded that, despite the fact that “prostate cancer is an ideal target for prevention,” there is in fact “no suitable evidence to recommend using any specific nutritional supplement or diet to prevent prostate cancer” at the present time. … READ MORE …

AUA comments on FDA guidance on safe use of 5-ARIs

The American Urological Association (AUA) has written to the U.S. Food & Drug Administration (FDA) seeking modification of the FDA’s recent guidance on the use of 5α-reductase inhibitors like dutasteride and finasteride in the management of urologic conditions. … READ MORE …

Targeting the 5α-reductase enzyme in treatment of prostate cancer

A recent review article concludes with the statement, “5α-reductase inhibition does seem to have beneficial effects on prostate cancer incidence, and the role of [5α-reductase inhibitors (5-ARIs)] in combination with other agents should be further evaluated for the treatment of [castration-resistant prostate cancer (CRPC)].” … READ MORE …

FDA publishes analysis of decision not to approve 5-ARIs for prostate cancer prevention

The “New” Prostate Cancer InfoLink is delighted to see Dr. Pazdur and colleagues from the U.S. Food & Drug Administration (FDA) present their reasoning for non-approval of the 5α-reductase inhibitors (5-ARIs) dutasteride and finasteride for prevention of prostate cancer in a new article in the New England Journal of Medicine. … READ MORE …

5α-Reductase inhibitors and risk for high-grade prostate cancer

Yesterday the US Food & Drug Administration (FDA) updated its guidance on the use of 5α-reductase inhibitors with specific reference to the risk that use of these products may be able to induce high-grade (and therefore high-risk) prostate cancer in a small subset of men treated with these agents. … READ MORE …

The short-term, potential future of prostate cancer prevention

A recent article in the Journal of General Internal Medicine argues that using 5α-reductase (5-ARI) therapy (i.e., with dutasteride or finasteride) to prevent the early onset of prostate cancer is not justified by the available data. … And we entirely agree, … READ MORE …

5-ARIs, active surveillance, and prostate cancer progression

We will presumably be at least a little wiser about this issue when data from the REDEEM trial are presented at the Genitourinary Cancers Symposium in Orlando on Thursday; however, data from Canada already suggest that 5α-reductase inhibitors (5-ARIs) affect progression of low-risk forms of prostate cancer. … READ MORE …

Finasteride, PSA doubling time, and intermittent hormone therapy

For years, some clinicians have been telling their patients to use a 5α-reductase inhibitors (5-ARIs) like finasteride or dutasteride as a form of “bridge” therapy to extend their periods of time off primary hormone therapy while being treated with intermittent hormone therapy or IHT. … READ MORE …

The AUA and ASCO jointly issue guideline on use of 5-ARIs to prevent prostate cancer

The “New” Prostate Cancer InfoLink is delighted to report that a joint ASCO/AUA task force has just issued a new set of guidelines recommending discussion between doctors and their patients about the potential use of 5α-reductase inhibitors (5-ARIs) such as finasteride or dutasteride as agents to reduce the risk of prostate cancer. … READ MORE …