Kang HW, et al. – Researchers performed a retrospective cohort study to evaluate the impact on PSA concentrations of low–dose finasteride or dutasteride treatment for male androgenetic alopecia whose baseline serum PSA < 2.5 ng/mL. It was considered that dutasteride and finasteride reduced PSA levels to similar degrees. This impact was found soon after commencing treatment. PSA levels can remain stable or even increase in patients with low baseline PSA levels. These outcomes are limited to men with baseline PSA < 2.5 ng/mL.

Methods

• Researchers conducted a cohort study including a sum of 1,379 consecutive male patients who were treated for androgenetic alopecia with finateride 1.25 mg daily or dutasteride 0.5 mg every 3 days in 2002–2012 and underwent PSA measurements at baseline and at least once thereafter.
• Thereafter, patients whose baseline or follow–up PSA level after prescription exceeded 2.5 ng/ml were excluded to rule out men with higher likelihood of prostate cancer.
• They stratified patients according to age, baseline PSA concentration, medication type, and treatment duration.

Results

• The data showed that the low–dose 5aRI treatment reduced PSA levels by 27.8% relative to baseline values.
• As evidence accumulates, most patients (n=1,094, 79.3%) displayed PSA declines (average=40.8%).
• It was noted that the remaining 285 (20.7%) patients demonstrated stable or increased PSA levels (average=24.2% increase).
• Closer analysis showed that, largely, only patients with baseline PSA levels of ≥0.5 ng/ml exhibited treatment–related PSA declines.
• The multivariate logistic analysis indicated that low baseline PSA levels was correlated significantly with stable/increased PSA levels.
• The data showed that low–dose dutasteride and finasteride reduced PSA levels to similar degrees (31.1% vs. 25.1%).
• Remarkably, marked PSA declines (26.0%) were found even after short–term (3–6 month) treatment.