Finasteride (prostate cancer chemoprevention context)
Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.
| ID | DRUG-FINASTERIDE-CHEMOPREVENTION |
|---|---|
| Тип | Препарат |
| Синоніми | Finasteride (prostate cancer chemoprevention)Propecia (1 mg — alopecia, not chemoprevention dose)Proscar (5 mg)Фінастерид (хіміопрофілактика раку передміхурової залози) |
| Статус | переглянуто 2026-05-18 | очікує клінічного підпису |
| Хвороби | Не вказано |
| Джерела | SRC-NCCN-PROSTATE-2025 SRC-USPSTF-PROSTATE-2018 |
Дані про препарат
| Клас | 5-alpha-reductase type 2 inhibitor |
|---|---|
| Механізм дії | Competitive inhibitor of 5-alpha-reductase type 2 isoenzyme; blocks conversion of testosterone to dihydrotestosterone (DHT) in prostate, hair follicles, and skin. Reduces intraprostatic DHT by ~85-90% while serum testosterone rises ~10-15%. Prostate cancer prevention rationale: lowering DHT reduces androgen-driven epithelial proliferation. Prostate Cancer Prevention Trial (PCPT, NCT00000484, Thompson NEJM 2003 + 2013 long-term): 25% relative reduction in prostate cancer incidence at 7 years but signal of increased Gleason ≥7 detection (re-analyzed and partly attributed to detection bias; long-term mortality not increased). |
| Типове дозування | Prostate cancer chemoprevention (controversial / off-label, PCPT protocol): 5 mg PO once daily ongoing. BPH dosing identical (5 mg/day). Time to plateau effect on intraprostatic DHT ~6 months; PSA values reduce by ~50% within 6-12 months — double measured PSA for cancer-screening interpretation in users. |
| Зареєстровано в Україні | True |
| Відшкодовується НСЗУ | False |
| Остання перевірка для України | 2026-05-18 |
Нотатки
STUB — v0.2 chemoprevention-workstream authoring; pending two-Clinical- Co-Lead signoff per CHARTER §6.1 dev-mode. CONTROVERSIAL chemoprevention indication. PCPT (Thompson NEJM 2003): 25% reduction in overall prostate cancer at 7 years BUT initially-reported increase in high-grade (Gleason 7-10) tumors. Subsequent reanalysis attributed much of the high-grade excess to detection bias (smaller prostate volume → easier biopsy detection); long-term mortality at 18 years not increased. AUA 2011 / USPSTF 2018 caution: shared decision-making required; no general- population recommendation. Strict pregnancy exclusion for partner; pregnant women must not handle. Engine should NOT auto-recommend; reserved for high-risk men opting in after explicit counseling.
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