[Finasteride in the treatment of benign prostatic hypertrophy]

Finasteride acts by blocking the conversion of testosterone to 5a-dihydrotestosterone, the active androgen metabolite in the human prostate. In large, double-blind, placebo-controlled phase III-studies recruiting over 1,600 patients, it was shown that the administration of Finasteride, either 5 or 1 mg a day, reduced the size of the prostate by a mean of 22%, following 6 months of therapy. Despite this reduction in prostate size, urinary flow rate only improved by a mean of 1.7 ml per second, and symptom score improved only marginally, but statistically significantly different from placebo. The future role for Finasteride therapy is emerging but it appears as if patients with mild to moderate symptoms would be a group who could benefit the most. Whether or not Finasteride can stop the long-term natural course of benign prostatic hyperplasia has still to be demonstrated.