2044 THE IMPACT OF COMMON MEDICATIONS ON SERUM PROSTATE-SPECIFIC ANTIGEN LEVELS: ANALYSIS OF NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY

Abstract

You have accessJournal of UrologyProstate Cancer: Markers I1 Apr 20102044 THE IMPACT OF COMMON MEDICATIONS ON SERUM PROSTATE-SPECIFIC ANTIGEN LEVELS: ANALYSIS OF NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY Steven Chang, Lauren Harshman, Jay Bhattacharya, and Joseph Presti Steven ChangSteven Chang More articles by this author , Lauren HarshmanLauren Harshman More articles by this author , Jay BhattacharyaJay Bhattacharya More articles by this author , and Joseph PrestiJoseph Presti More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2091AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Previous studies suggest that some medications may lower serum prostate-specific antigen (PSA) levels. It remains unclear if these previously reported medication effects are due to sociodemographic factors, and clinical characteristics, or concurrent use of other medications. We investigated the impact of individual and combinations of common medications on serum total PSA in a large cross-sectional study of the civilian, non-institutionalized United States population. METHODS The study population included men at least 40 years of age without prostate cancer from the 2003-2004 and 2005-2006 cycles of the National Health and Nutrition Examination Survey (NHANES). We excluded men with recent prostate manipulation and those taking 5-alpha reductase inhibitors or hormone therapy. Weighted linear regression was performed on log-transformed serum total PSA to determine the effect of the 10 most commonly prescribed medication classes after adjusting for sociodemographic and clinical factors including physical examination, relevant laboratory studies, and duration of medication use. RESULTS 1,846 men met inclusion criteria. Nonsteroidal anti-inflammatory drugs (NSAIDs) (p=0.036), statins (p=0.008) and thiazide diuretics (p=0.032) were associated with lower total PSA levels. The models predicted that men regularly using NSAIDs, statins, and thiazide diuretics had total PSA levels reduced by 6%, 13%, and 27% at 5 years and 11%, 26%, and 47% at 10 years, respectively. The combined use of statins and thiazide diuretics was associated with the greatest decrease in total PSA levels: 36% and 59% after 5 and 10 years, respectively. The relationship of statin use and total PSA levels was negated with the concurrent use of calcium channel blockers. No other common medication demonstrated a relationship with total PSA levels. CONCLUSIONS Although most common medications are unrelated to total PSA level, men who consume NSAIDs, statins, and thiazide diuretics have reduced total PSA levels by clinically relevant amounts. The regular use of NSAIDs, statins, or thiazide diuretics may impact the quality of prostate cancer screening. Stanford, CA© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e793-e794 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Steven Chang More articles by this author Lauren Harshman More articles by this author Jay Bhattacharya More articles by this author Joseph Presti More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...