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01.03.2023 | Urology - Original Paper

A prospective evaluation of the effect of finasteride on prostate health index (phi)

verfasst von: Peter Ka-Fung Chiu, Chun-Hong Chan, Alex Qinyang Liu, Sui-Yan Lau, Chi-Ho Leung, Yun-Sang Chan, Steffi Kar-Kei Yuen, Chi-Hang Yee, Jeremy Yuen-Chun Teoh, Wai-Lun Tang, Wing-Tat Poon, Chi-Fai Ng

Erschienen in: International Urology and Nephrology | Ausgabe 5/2023

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Abstract

Purpose

5-alpha reductase inhibitor (5ARI) reduces prostate-specific antigen (PSA) by half but its effect on prostate health index (phi) is unknown. This study aims to investigate this effect and to enable accurate interpretation of phi in men with elevated PSA and on 5ARI.

Methods

This is a prospective study evaluating the effect of finasteride on PSA, free PSA (fPSA), [ – 2]proPSA (p2PSA) and phi at 6 and 12 moths in men with PSA 4-20 ng/mL, no prior 5ARI use, and one negative prostate biopsy within 6 months before recruitment. The 5ARI Finasteride (5 mg/day) for 1 year was offered if International Prostatic Symptom Score (IPSS) was ≥ 8 at baseline. 5ARI group included patients taking finasteride, while control group included patients not on finasteride. The blood results were compared with t-test between baseline and different time points in each group and between groups at 1 year.

Results

164 men fit the inclusion criteria and 150 were analyzed. In 5ARI group (n = 100) at 1 year, mean PSA reduced by 51.4% from 8.9(± SD 3.7) to 4.4(± SD 2.8)ng/mL (paired t-test, p < 0.001), fPSA reduced by 52.4% from 1.6(± 0.6) to 0.8(± 0.4)ng/mL (p < 0.001), p2PSA reduced by 55.3% from 18.4(± 8.8) to 8.3(± 5.6)pg/mL (p < 0.001), and phi reduced by 34.2% from 33.7(± 11.9) to 22.4(± 12.5) (p < 0.001). PSA and phi values in the control group remained static over 1 year and significantly higher than those in 5ARI group.

Conclusion

This study demonstrated p2PSA and phi are reduced by about 55% and 34% in men on 5ARI. A conversion factor of division by 0.66 is needed for phi in men on finasteride to allow the interpretation and use of phi in men on 5ARI.

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Titel: A prospective evaluation of the effect of finasteride on prostate health index (phi)
verfasst von: Peter Ka-Fung Chiu
Chun-Hong Chan
Alex Qinyang Liu
Sui-Yan Lau
Chi-Ho Leung
Yun-Sang Chan
Steffi Kar-Kei Yuen
Chi-Hang Yee
Jeremy Yuen-Chun Teoh
Wai-Lun Tang
Wing-Tat Poon
Chi-Fai Ng
Publikationsdatum: 01.03.2023
Verlag: Springer Netherlands
Erschienen in: International Urology and Nephrology / Ausgabe 5/2023
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-023-03530-3

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A prospective evaluation of the effect of finasteride on prostate health index (phi)