Journal List > Korean J Urol > v.47(4) > 1069866

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Cho, Lee, Kim, Kim, Kim, Noh, Rhew, Park, Park, Park, Park, Seo, Oh, Lee, Chung, Jung, Chung, Jung, Cho, and Kim: The Influence of Chlormadinone Acetate on the Total and Free Serum Prostate Specific Antigen Levels in Men with Benign Prostatic Hyperplasia
Original Article
Korean Journal of Urology

Korean Journal of Urology 2006; 47(4): 368-371.

Published online: 30 April 2006

DOI: https://doi.org/10.4111/kju.2006.47.4.368

The Influence of Chlormadinone Acetate on the Total and Free Serum Prostate Specific Antigen Levels in Men with Benign Prostatic Hyperplasia

Jin Seon Cho, Kyung Seop Lee1, Bup Wan Kim2, Sae Woong Kim3, Choung Soo Kim4, Choong Hee Noh5, Hyun Yul Rhew6, Kwangsung Park7, Dong Soo Park8, Jae Shin Park9, Jong Kwan Park10, Ill Young Seo11, Tae Hee Oh12, Sang Eun Lee13, Byung Ha Chung14, Se Il Jung15, Jae Il Chung5, Hee Chang Jung16, In Rae Cho5, Chun Il Kim17

Department of Urology, College of Medicine, Hallym University, Chuncheon, Korea.

1Department of Urology, Dongguk University, Gyeongju, Korea.

2Department of Urology, Kyungpook National University, Daegu, Korea.

3Department of Urology, The Catholic University of Korea, Seoul, Korea.

4Department of Urology, Asan Medical Center, Seoul, Korea.

5Department of Urology, Inje University, Busan, Korea.

6Department of Urology, Kosin University, Busan, Korea.

7Department of Urology, Chonnam National University, Gwangju, Korea.

8Department of Urology, Pochon CHA University, Seongnam, Korea.

9Department of Urology, Daegu Catholic University, Daegu, Korea.

10Department of Urology, Chonbuk National University, Jeonju, Korea.

11Department of Urology, Wonkwang University, Iksan, Korea.

12Department of Urology, Sungkyunkwan University, Masan, Korea.

13Department of Urology, Seoul National University, Seoul, Korea.

14Department of Urology, Yonsei University, Seoul, Korea.

15Department of Urology, Dong-A University, Busan, Korea.

16Department of Urology, Yeungnam University, Daegu, Korea.

17Department of Urology, Keimyung University, Daegu, Korea.

Corresponding author (cikim@dsmc.or.kr)

Received 23 September 2005       Accepted 3 February 2006

Copyright © 2006 The Korean Urological Association

Abstract

Purpose

Chlormadinone acetate (CMA) therapy for benign prostatic hyperplasia (BPH) may lower the serum prostate specific antigen (PSA) level. However, little is known about the effect of CMA on the total or free serum PSA levels of PSA. Such information would be important since PSA testing is useful for prostate cancer screening. Thus, we prospectively studied the effect of CMA therapy on the total and free serum PSA levels.

Materials and Methods

The patients with lower urinary tract symptoms (LUTS) and BPH who were aged over 50 years were treated with 50mg CMA for 6 months. Men with a PSA level greater than 10ng/ml were excluded to reduce the likelihood of including cases of occult prostate cancer. Those with suspicious findings on the digital rectal examination and serum PSA testing were biopsied to rule out prostate cancer. α-blocking agents were permitted to treat the men with LUTS. Serum levels of the total and free PSA were measured at the study baseline and after approximately 3 and 6 months. The prostate volume (PV) was assessed by transrectal ultrasonography.

Results

The analysis included 170 patients with a mean age of 67.9 years, a baseline PV of 47.3ml and a baseline total PSA of 4.1ng/ml. The total PSA levels declined from 4.1ng/ml at baseline to 2.0ng/ml after 6 months of treatment (50.7% decrease, p<0.01). The mean percent free PSA (21% to 22% at baseline) was not significantly altered by CMA treatment. The PSA levels and PV at baseline did not affect the rate of decline of PSA.

Conclusions

The total PSA serum levels decreased by an average of 50% during CMA therapy, but the percent free PSA did not change significantly. This information is potentially useful in the interpretation of the PSA data that's used for early detection of prostate cancer in the men receiving CMA.

Keywords: Chlormadinone acetate, Prostate-specific antigen, Benign prostatic hyperplasia

Figures and Tables

Fig. 1
Influence of chlormadinone acetate on prostate-specific antigen according to the prostate volume in the men with benign prostatic hyperplasia.
kju-47-368-g001
Table 1
Baseline characteristics of the patients
kju-47-368-i001

TRUS: transrectal ultrasonography, Mean±standard deviation

Table 2
Influence of chlormadinone acetate on prostate-specific antigen in men with benign prostatic hyperplasia
kju-47-368-i002

CI: confidence interval, Mean±standard error

Table 3
Influence of chlormadinone acetate on the free PSA and the % free PSA in the men with benign prostatic hyperplasia
kju-47-368-i003

CI: confidence interval, Mean±standard error

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Kwangsung Park
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