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A randomized biopsy study showed that hexanic  Serenoa repens  (HESr) treatment resulted in prostatic inflammation reduction. This post-hoc analysis evaluated the clinical impact of HESr and investigated correlations between baseline parameters and treatment response. Patients were randomized to receive HESr 320mg/day for six months or no therapy. Assessment included International Prostate Symptoms Score (IPSS), prostate volume (PV), and maximum flow rate (Qmax). Baseline characteristics were recorded, including body mass index (BMI) and metabolic syndrome (MetS) components. In patients under α1-adrenoceptor antagonists (α1-blockers), the addition of HESr resulted in statistically significant IPSS improvement after 6 months ( p  = 0.006). IPSS remained stable in patients under a1-blockers only ( p  = 0.346). Patients treated only with HESr reported a significant IPSS amelioration ( p  = 0.001). In the control group of naïve patients, no significant IPSS change was detected ( p  = 0.298). Baseline PV showed fair correlation ( r  = −0.20) with inflammation reduction in the HESr patients. BMI ( r  = 0.40), diabetes mellitus ( r  = 0.40), and PV ( r  = 0.23) showed fair correlation with Qmax increase but without reaching statistical significance. MetS ( p  = 0.06) was an influent biomarker for Qmax improvement. Treatment with HESr (as monotherapy or add-on therapy to a-blockers) may improve urinary symptoms in terms of IPSS in patients with prostatic inflammation.

The Clinical Impact of Hexanic Extract of Serenoa repens in Men with Prostatic Inflammation: A Post Hoc Analysis of a Randomized Biopsy Study