Does prolonged anti-inflammatory therapy reduce number of unnecessary repeat saturation prostate biopsy?

Arch Ital Urol Androl. 2013 Jun 24;85(2):65-8. doi: 10.4081/aiua.2013.2.65.

Abstract

Introduction: The effect of a prolonged oral anti-inflammatory therapy on PSA values in patients with persistent abnormal PSA values after negative prostate biopsy (PBx) was evaluated.

Material and methods: From September 2011 to September 2012, 70 patients (medi- an age 62 years), with persistent abnormal PSA values after negative extended PBx, were given an herbal extract with anti-inflammatory activity for 3 months (Lenidase®; 1 tablet daily constituted of baicalina, bromelina and escina). All patients were submitted to prostate biopsy for: abnormal DRE; PSA > 10 ng/mL, PSA values between 4.1-10 or 2.6-4 ng/mL with free/total PSA < 25% and < 20%, respectively. Three months after the end of anti-inflammato- ry therapy all patients were revaluated; indication for repeat saturation biopsy (SPBx) and detection rate for PCa were compared with those previously recorded in our Department using the same inclusions criteria for biopsy.

Results: Oral administration of Lenidase® was well tolerated and no side effects were observed; PSA values decreased in 54 (77.8%) out 70 patients with a median PSA reduction of 20.5% (from 8.8 to 7 ng/mL) and remained unchanged in 16 patients (22.2%); the repeat SPBx rate resulted significantly lower (22.8% vs 35.5%; p < 0.05) showing a superimposable detection rate for PCa (3 cases) in comparison with our previous data (18.7% vs 22%).

Conclusions: In our preliminary data a prolonged oral anti-inflammatory therapy reduced PSA levels in patients with negative PBx and persistent suspicious for PCa decreasing the indication to perform repeat SPBx (about 30% of the cases).

Publication types

  • Clinical Trial

MeSH terms

  • Adenocarcinoma / blood
  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / epidemiology
  • Adenocarcinoma / pathology
  • Administration, Oral
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Biopsy / statistics & numerical data*
  • Diagnosis, Differential
  • Humans
  • Male
  • Middle Aged
  • Phytotherapy*
  • Plant Preparations / administration & dosage
  • Plant Preparations / therapeutic use*
  • Prospective Studies
  • Prostate / pathology*
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / diagnosis
  • Prostatic Neoplasms / epidemiology
  • Prostatic Neoplasms / pathology
  • Prostatitis / blood
  • Prostatitis / drug therapy
  • Prostatitis / pathology
  • Severity of Illness Index
  • Unnecessary Procedures

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Lenidase
  • Plant Preparations
  • Prostate-Specific Antigen