MP35-02 BENIGN PROSTATIC HYPERPLASIA AND AUTOIMMUNE INFLAMMATORY DISEASES COINCIDENCE AND CONSEQUENCES

Abstract

INTRODUCTION AND OBJECTIVES: Inflammation is common in benign prostatic hyperplasia (BPH) and is thought to contribute to resistance to 5ARI therapy. BPH exhibits molecular and physical characteristics similar to those seen in autoimmune inflammatory (AI) conditions such as rheumatoid arthritis. We set out to examine two questions; first, whether diagnoses of BPH and an AI condition are at an increased likelihood of occurring in the same patient and second, whether patients diagnosed and treated for an AI condition had an altered incidence of subsequent BPH. METHODS: We extracted deidentified patient data from an electronic data warehouse covering men over the age of 40 presenting at NorthShore clinics over a period of three years (1/1/09-12/31/11). The cohort included a control group of 72,503 men with no history of AI and 8,203 men with a diagnosis of one or more of a panel of AI conditions. These groups were subdivided into men with and without a diagnosis of BPH, type of AI condition, and whether the AI condition occurred before or after the diagnosis of BPH. Rates were compared between groups using chi-square test. RESULTS: In the control group of 72,503 men, a total of 17,113 (23.6%) were diagnosed with BPH. Of the 8,203 men with an AI diagnosis, 2,774 (33.8%) were also diagnosed with BPH, demonstrating a significant positive association between AI conditions and BPH (p<0.01). However when men were diagnosed with and treated for an AI condition, their chance of a subsequent BPH diagnosis dropped significantly, and, overall, was slightly, but significantly, lower than the control baseline at 20.9% (p<0.01). Further analysis revealed that some conditions (rheumatoid arthritis (RA), Crohns disease and vasculitis) are associated with significantly higher rates of BPH while others (psoriasis, systemic lupus erythematosus, and multiple sclerosis) are associated with significantly lower rates of BPH. Further, treatments for some conditions, e.g.psoriasis, resulted in significant decreases in subsequent BPH diagnoses, while treatment for other conditions, e.g. RA, had less profound effects. CONCLUSIONS: This study reveals clear associations between BPH and AI diagnoses and is strongly suggestive that some medical approaches applied to AI disorders may affect the pathogenesis and progression of BPH. Differences in the coincidence and treatment effects of therapies for various conditions may reflect the individual disease and drug characteristics and bear further examination. Further analysis of these data by treatment and effect may allow introduction of additional medical treatment options for progressive BPH.