MP09-17 5-ALPHA REDUCTASE INHIBITORS FOR TREATMENT OF BENIGN PROSTATIC HYPERPLASIA DOES NOT INCREASE THE RISK OF ERECTILE DYSFUNCTION

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Medical & Non-surgical Therapy1 Apr 2017MP09-17 5-ALPHA REDUCTASE INHIBITORS FOR TREATMENT OF BENIGN PROSTATIC HYPERPLASIA DOES NOT INCREASE THE RISK OF ERECTILE DYSFUNCTION Katrina Hagberg, Hozefa Divan, Rebecca Persson, Susan Jick, and J. Curtis Nickel Katrina HagbergKatrina Hagberg More articles by this author , Hozefa DivanHozefa Divan More articles by this author , Rebecca PerssonRebecca Persson More articles by this author , Susan JickSusan Jick More articles by this author , and J. Curtis NickelJ. Curtis Nickel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.325AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES 5-alpha reductase inhibitors (5ARIs) have been reported to increase the risk of erectile dysfunction (ED) in patients treated for benign prostatic hyperplasia (BPH); however BPH itself is an ED risk factor (potential confounding by indication). We conducted a cohort study with nested case-control analyses using the United Kingdom's Clinical Practice Research Datalink to estimate the risk of ED in men who used 5ARIs for the treatment of BPH. METHODS We identified men aged 40+ with BPH who received at least one prescription for a 5ARI (finasteride or dutasteride), alpha blocker (AB), or both. Exposures were classified as 5ARI only, 5ARI+AB, and AB only. Cases were men who had a first ED diagnosis or treatment (surgery or phosphodiesterase type-5 inhibitor prescription) during follow-up. We calculated incidence rates (IRs) and adjusted incidence rate ratios (IRRs) with 95% confidence intervals (CIs). We also conducted a nested case-control analysis to control for major confounders and calculated adjusted odds ratios (ORs) with 95%CIs. RESULTS We identified 71,849 men, among whom 5,814 were identified as new cases of ED over the 20 year study period (1992-2011). The incidence rate of ED was lowest among users of 5ARI only (15.3 per 1000 person-years) and similar among users of 5ARI+AB (19.2 per 1000 person-years) and AB only (20.1 per 1000 person years). The risk of ED was not elevated with use of 5ARI only (IRR=0.92, 95%CI 0.85-0.99) or 5ARI+AB (IRR=1.09, 95%CI 0.99-1.21) in comparison with AB only. In the nested case-control analysis, ORs were 0.94 (95%CI 0.85-1.03) for 5ARI only and 0.92 (95%CI 0.80-1.06) for 5ARI+AB, compared to AB only, and remained null regardless of number of prescriptions or exposure timing. The risk of ED increased with longer duration of BPH, independent of exposure. CONCLUSIONS In a large, 20 year, real world observational study, 5ARI therapy for BPH does not significantly increase the risk of clinically meaningful incident ED compared to AB treatment. Risk of ED increased with longer duration of BPH. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e106-e107 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Katrina Hagberg More articles by this author Hozefa Divan More articles by this author Rebecca Persson More articles by this author Susan Jick More articles by this author J. Curtis Nickel More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...