@article {Nickel1251, author = {J. C. Nickel and Y. Fradet and R. C. Boake and P. J. Pommerville and J. P. Perreault and S. K. Afridi and M. M. Elhilali}, title = {Efficacy and safety of finasteride therapy for benign prostatic hyperplasia: results of a 2-year randomized controlled trial (the PROSPECT study). PROscar Safety Plus Efficacy Canadian Two year Study}, volume = {155}, number = {9}, pages = {1251--1259}, year = {1996}, publisher = {CMAJ}, abstract = {OBJECTIVE: To evaluate the efficacy and safety of 2 years{\textquoteright} treatment of moderate benign prostatic hyperplasia (BPH) with finasteride. DESIGN: Double-blind, parallel-group, placebo-controlled, multicentre, prospective randomized study. SETTING: Outpatient care in 28 centres across Canada. PARTICIPANTS: Men aged 45 to 80, in good health, with moderate BPH and no evidence of prostate cancer. A total of 613 men were entered into the study; 472 completed the 2 years of treatment. INTERVENTION: After 1 month of receiving a placebo (run-in period), patients were given either finasteride (5 mg/d) or a placebo for 2 years. OUTCOME MEASURES: Efficacy: changes from baseline in BPH symptom scores, maximum urinary flow rates and prostate volume. Safety: onset, course and resolution of all adverse events during the treatment period. RESULTS: In the efficacy analyses the mean BPH symptom scores decreased 2.1 points (from 15.8 to 13.7) in the finasteride group, as compared with a decrease of 0.7 points (from 16.6 to 15.9) in the placebo group (P \< or = 0.01). The maximum urinary flow rate increased by a mean of 1.4 mL/s (from 11.1 to 12.5 mL/s) in the finasteride group, as compared with an increase of 0.3 mL/s (from 10.9 to 11.2 mL/s) in the placebo group (p \< or = 0.01). The mean prostate volume decreased by 21\% (from a mean volume of 44.1 cm3 at baseline) in the treatment group; it increased by 8.4\% (from a mean volume of 45.8 cm3 at baseline) in the placebo group (p \< or = 0.01). In the safety analysis, the proportion of patients who experienced any adverse event was similar in the two groups (81.0\% in the treatment group and 81.2\% in the placebo group). However, the incidence of adverse events related to sexual dysfunction were significantly higher in the finasteride group than in the placebo group (ejaculation disorder 7.7\% v. 1.7\% and impotence 15.8\% v. 6.3\%; p \< or = 0.01 for both parameters). CONCLUSION: Finasteride is a well-tolerated and effective alternative to watchful waiting in the treatment of moderate BPH.}, issn = {0820-3946}, URL = {https://www.cmaj.ca/content/155/9/1251}, eprint = {https://www.cmaj.ca/content}, journal = {CMAJ} }