Dutasteride does not increase CV risk relative to finasteride
It appears that dutasteride does not elevate the risk of cardiovascular (CV) events in relation to finasteride, suggest the results of a recent population-based cohort study.
To investigate the risk of CV events among patients receiving dutasteride (n=36,311) compared with finasteride (n=36,311), researchers analysed Ontario men (≥66 years) who commenced treatment with dutasteride or finasteride between 1 October 2005 and 31 March 2015. Participants were matched 1:1 based on a propensity score and calendar quarter of treatment initiation to account for temporal changes in prescribing.
Hospitalization for heart failure was the primary outcome. Secondary analyses were performed to examine acute myocardial infarction and stroke. To adjust for differences between groups, researchers used Cox proportional hazards regression.
Primary analysis showed no difference in the risk of heart failure among patients receiving dutasteride relative to those receiving finasteride (adjusted hazard ratio [HR], 0.98; 95 percent CI, 0.88 to 1.08). Similarly, there was no difference observed in the risk of acute myocardial infarction (HR, 0.94; 0.82 to 1.08) or stroke (HR, 1.03; 0.88 to 1.20).
A study by Cindolo and colleagues in 2013 suggested that the clinical effects of dutasteride and finasteride might be different. Patients treated with dutasteride appeared to be less likely to have benign prostatic hyperplasia-related hospitalization. [World J Urol 2013;31:665-71; Arch Ital Urol Androl 2013;85:200-6]
In another study, a retrospective analysis of data from consecutive patients treated at a single clinic found that both finasteride and dutasteride were effective for the management of lower urinary tract symptoms. However, dutasteride had significantly more sexual side effects and breast complications than finasteride. [Int J Clin Pract 2012;66:1052-5]
Dutasteride inhibits both type 1 and type 2 isoforms of 5α-reductase, while finasteride selectively inhibits the type 2 isoform, according to researchers.