Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Mar;11(3):313-324.
doi: 10.21037/tau-22-58.

The efficacy and safety of dutasteride and finasteride in patients with benign prostatic hyperplasia: a systematic review and meta-analysis

Yao Li  1 , Jie Ma  1 , Xin-Hua Qin  1 , Chuan-Yi Hu  1
Affiliations

The efficacy and safety of dutasteride and finasteride in patients with benign prostatic hyperplasia: a systematic review and meta-analysis

Yao Li et al. Transl Androl Urol. 2022 Mar.

Abstract

Background: Although the efficacy and safety of monotherapy in the treatment of benign prostatic hyperplasia (BPH) have been established clinically, the efficacy and safety of dutasteride and finasteride have not been compared. The aim was to systematically evaluate the efficacy and safety of the two drugs in the treatment of BPH to provide medical evidence for clinical treatment.

Methods: A search of relevant articles was conducted using the electronic databases PubMed, Embase, Medline, Cochrane Library, China Academic Journals Full-text Database (CJFD), Chinese Science and Technology Journal Database (VIP) and Wanfang Database. Randomized controlled trials (RCTs) comparing the efficacy of finasteride (control group) with that of dutasteride (experimental group) in the treatment of BPH with respect to the International Prostate Symptom Score (IPSS), the maximum urinary flow rate (Qmax), prostate volume (PV), quality of life (QOL), serum prostate-specific antigen (PSA) level and adverse drug reactions (ADRs) after medication were strictly evaluated and considered for inclusion. Rev Man 5.4 software was used for the meta-analysis.

Results: A total of 8 RCTs were included, with a total of 2,116, patients. The meta-analysis showed that compared with finasteride, dutasteride can effectively improve the Qmax of patients with BPH [mean difference (MD) =0.32; 95% confidence interval (CI): (0.01, 0.63); P=0.04]. There was no significant difference in reducing IPSS [MD =0.13; 95% CI: (-0.55, 0.82); P=0.70], improving PV [MD =-1.25; 95% CI: (-3.30, 0.79); P=0.23], reducing QOL [MD =-0.44; 95% CI: (-0.93, 0.05); P=0.08] and serum PSA level [MD =-0.04; 95% CI: (-0.15, 0.07); P=0.50], and the occurrence of ADRs [relative risk (RR) =-0.01; 95% CI: (-0.05, 0.04); P=0.72], there was no significant difference.

Discussion: Dutasteride is better than finasteride in improving the Qmax of patients with BPH. There was no statistically significant difference in symptoms, PV, PSA, QOL, or adverse reactions. Dutasteride is an effective and safe treatment for BPH. Due to the limitations of the methodological quality and sample size of the included studies, this conclusion needs to be verified by stratified RCTS with high volumes and long follow-up times.

Keywords: Dutasteride; benign prostatic hyperplasia (BPH); finasteride; meta-analysis.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tau.amegroups.com/article/view/10.21037/tau-22-58/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Literature search flow chart.
Figure 2
Figure 2
Risk of bias for the 8 included studies.
Figure 3
Figure 3
Risk of bias summary for the 8 included studies. +: low risk of bias; −: high risk of bias; ?: unclear risk of bias.
Figure 4
Figure 4
Forest plot of the IPSS of patients with BPH treated with dutasteride or finasteride. SD, standard deviation; CI, confidence interval; IPSS, International Prostate Symptom Score; BPH, benign prostatic hyperplasia.
Figure 5
Figure 5
Forest plot of the Qmax in patients with BPH treated with dutasteride or finasteride. SD, standard deviation; CI, confidence interval; Qmax, maximum urinary flow rate; BPH, benign prostatic hyperplasia.
Figure 6
Figure 6
Forest plot of PV in patients with BPH treated with dutasteride or finasteride. SD, standard deviation; CI, confidence interval; PV, prostate volume; BPH, benign prostatic hyperplasia.
Figure 7
Figure 7
Forest plot of the QOL of patients with BPH treated with dutasteride or finasteride. SD, standard deviation; CI, confidence interval; QOL, quality of life; BPH, benign prostatic hyperplasia.
Figure 8
Figure 8
Forest plot of serum PSA levels of patients with BPH treated with dutasteride or finasteride. SD, standard deviation; CI, confidence interval; PSA, prostate-specific antigen; BPH, benign prostatic hyperplasia.
Figure 9
Figure 9
Forest plot of adverse effects of dutasteride and finasteride in patients with BPH. CI, confidence interval; BPH, benign prostatic hyperplasia.
Figure 10
Figure 10
Funnel plots of randomized controlled studies included in the meta-analysis. (A) Funnel plots of studies included IPSS. (B) Funnel plots of studies included Qmax. (C) Funnel plots of studies included PV. (D) Funnel plots of studies included QOL. (E) Funnel plots of studies included PSA. (F) Funnel plots of studies included adverse events. SMD, standard mean difference; IPSS, International Prostate Symptom Score; Qmax, maximum urinary flow rate; PV, prostate volume; QOL, quality of life; PSA, prostate-specific antigen.
Figure 11
Figure 11
Sensitivity analysis of meta-analysis literature. (A) Sensitivity analysis of meta-analysis literature included IPSS. (B) Sensitivity analysis of meta-analysis literature included Qmax. (C) Sensitivity analysis of meta-analysis literature included PV. (D) Sensitivity analysis of meta-analysis literature included QOL. (E) Sensitivity analysis of meta-analysis literature included PSA. (F) Sensitivity analysis of meta-analysis literature included adverse events. SMD, standard mean difference; CI, confidence interval; IPSS, International Prostate Symptom Score; Qmax, maximum urinary flow rate; PV, prostate volume; QOL, quality of life; PSA, prostate-specific antigen.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Wang W, Guo Y, Zhang D, et al. The prevalence of benign prostatic hyperplasia in mainland China: evidence from epidemiological surveys. Sci Rep 2015;5:13546. 10.1038/srep13546 - DOI - PMC - PubMed
    1. Tacklind J, Fink HA, Macdonald R, et al. Finasteride for benign prostatic hyperplasia. Cochrane Database Syst Rev 2010;(10):CD006015. - PMC - PubMed
    1. Zhou Z, Cui Y, Wu J, et al. Meta-analysis of the efficacy and safety of combination of tamsulosin plus dutasteride compared with tamsulosin monotherapy in treating benign prostatic hyperplasia. BMC Urol 2019;19:17. 10.1186/s12894-019-0446-8 - DOI - PMC - PubMed
    1. Ciríaco SL, Carvalho IPS, Alves Terceiro Neto J, et al. Development of microemulsion of tamsulosin and dutasteride for benign prostatic hyperplasia therapy. Colloids Surf B Biointerfaces 2020;185:110573. 10.1016/j.colsurfb.2019.110573 - DOI - PubMed
    1. Kosilov KV, Kuzina IG, Kuznetsov V, et al. Improvement of the symptoms of lower urinary tract and sexual dysfunction with tadalafil and solifenacin after the treatment of benign prostatic hyperplasia with dutasteride. Prostate Int 2020;8:78-84. 10.1016/j.prnil.2019.11.005 - DOI - PMC - PubMed