More evidence inflammation not linked to CPPS

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URS 2007 - Clinical Association of Inflammation in 8,224 Baseline Prostate Biopsies from the REDUCE Trial - Abstract

Presented October 25th - 28th, 2007 at the 2007 Urological Research Society (URS) Meeting - Napa, California

Objective: The ongoing REDUCE trial is a 4-year, phase III, placebo-controlled study to determine if daily dutasteride 0.5 mg reduces the risk of biopsy-detectable prostate cancer in men at risk. Prostate biopsies performed in all men prior to entry were centrally reviewed, thus allowing an examination of the relationship between inflammatory changes, prostatitis-like symptoms and lower urinary tract symptoms (LUTS)

Methods: Eligible men were 50-75 years old, with serum prostate-specific antigen ≥2.5 ng/mL and ≤10 ng/mL (50-60 years) or ≥ 3.0 ng/mL and ≤10 ng/mL (>60 years), and an International Prostate Symptom Score (IPSS) <25 (or <20 if already on alpha-blocker therapy). Acute prostatitis was an exclusion criterion. For a given individual, inflammation was assessed across all cores and the amount of inflammation scored as none (0), mild (1), moderate (2), or marked (3). Prostatitis and LUTS were assessed using the CPSI and IPSS respectively. The relationships between inflammation scores and total CPSI, IPSS, and sub-scores were then examined using linear regression analyses

Results: Data was available for 5,597 for prostatitis and 8,224 men for LUTS evaluation. Acute and chronic histological prostatitis was observed in 15.4% and 77.6% of the baseline prostate biopsies. At baseline, 21.6% showed no inflammation. A chronic prostatitis-like symptom syndrome was noted in 6.9% of men. The mean IPPS score was 8.7 (+/-5.7). There was no significant association between histological prostatitis and clinical prostatitis-like symptoms. However, there was a significant, but weak, association with BPH related LUTS

Conclusions: In the REDUCE population, there is evidence of a relationship between the degree of chronic inflammation and LUTS but not clinical prostatitis symptoms. The impact of baseline prostate inflammation on progression of LUTS and/or associated complications (as well as development of prostate cancer) will be determined during four-year longitudinal follow-up.

Authors: Nickel JC, Roehrborn CG, O'Leary MP, Bostwick DG, Somerville MC, and Rittmaster RS