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, ..
" "-TOP 10
50
Rank
Disease
51.3
2
3
4
5
6
7
8
9
10
Hypertension
Diabetes Mellitus Type 2
Enlarged Prostate
Osteoarthritis
Arrhythmias
Cataract
Gastroesophogeal reflux disease
Bursitis
Prostate Cancer
45.2
17.5
13.5
13.3
8.8
8.6
8.4
8.0
7.8
5
(),
5-,
(1).
5- 2,
5- 1 2 (
5-).
,
.
5-
Type II
5AR
Testos
terone
DHT
Type I
5AR
Type II
5AR
Testost
erone
D
H
T
Type I
5AR
20
Mean change in serum
PSA (%)
10
0
-10
2.8
2.2
10.
7
6.8
5.5
15.
8
Placeb
o
9.2
-20
-30
35.7
43.5
-40
48.6
50.5
-50
-60
Baseli
ne
Data on file, GlaxoSmithKline.
1
Mo 2
nth
1
5
18
Dutasteri
de
52.4
2
1
2
4
12
.
5- :
.
(3-5 ).
5-
.
DHT 70%
95% .
, DHT
6 12 .
2 4 , 5
(IPSS) 15-30%,
18-28%
Qmax
1,5-2,0 /
(. 5) (4-13).
, IPSS,
,
.
Qmax
30
40 (15,16).
,
(3).
,
5-
Double-blind
Open-label
6.7%
6
P/D
D/D
57%
3.3%
3
2
1
0
0
12
18
24
Treatment month
30
36
42
48
30 (
CombAT 55 )
, 5-
,
,
(11,12).
(
),
(19).
IPSS
58 (> 4,4)
15
5- -
/ /
(8,10,19,20).
40 (12,13,20).
5
,
.
5-
.
,
5-
( ).
.
, 5-
(),
,
, -
(23).
EAU GUIDELINES
Recommendations
- +
5-
.
, ,
.
.
.
CombAT (Combination of
AvodartR and Tamsulosin)
trials
PSA , ,
.
,
6 12
.
,
Qmax
Double-blind
Open-label
5.6%
P/D
D/D
48%
3.3%
3
2
1
0
0
12
18
24
Treatment month
30
36
42
48
MTOPS
CombAT
IPSS
4 ,
, ,
50%. MTOPS CombAT
trial, :
66% 44%
64% 41%
81% 68%
65% 26%
67% 71%
CombAT
MTOPS,
.
-
5-.
5,
,
Qmax,
.
,
.
EAU GUIDELINES
Recommendations
IPSS
12 .
6
(n=2351)
1.4
6.3
8.1*
5
finasteride (Proscar)5 mg daily
$92.99 / 30
dutasteride (Avodart)0.5 mg daily
$87.99 / 30
!
- 17 000 /
- 17 000
/
8-15 000
3 000 -5 000
5-15 000
5 000
,
2
, ,
1000-1500 USD
REDUCE Trail
1-2, n=3364,
3244
3- 4, n=2359,
2451
n=3424,
3305
0,5
578
435
280
224
858
659
P Value
95%
Mantel-Cox
<0.0001
22.8
( 15.2 to 29.8 )
Reduction by Dutasteride of
Prostate Cancer Events
(REDUCE)
, //
.
4 .
GSK , 650
, 8000
50-75 , PSA 2.5-3.0 - 10 ng/ml,
6
Andriole et al. J Urology 2004
. ( HGPIN
ASAP),
80
cc
April
27, 2009 report
at the
American Urological Association annual meeting in Chicago, IL
:
,
( , ..)
, (PSA
) .
: 2
.
3 ,
4
, ,
.
.
!
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