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24-10-2019 | Oncology | News | Article

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Association between 5α-reductase inhibitors, prostate cancer mortality replicated

medwireNews: An analysis of the SEER–Medicare database has confirmed the link between use of 5α-reductase inhibitors (5-ARIs), primarily for benign prostatic enlargement, and increased risk for prostate cancer-specific and all-cause mortality.

“These results are consistent with our recently published findings” based on data from the US Veterans Affairs healthcare system, say Brent Rose and co-authors from the University of California, San Diego, in La Jolla, USA.

Of 30,313 men diagnosed with stage I–IV prostate cancer between 2008 and 2013, the 7.83% who used the 5-ARIs finasteride or dutasteride at least 6 months prior to the diagnosis were significantly more likely to present with high-grade (Gleason score ≥8) and high-risk disease than their counterparts who did not, at 29% versus 18% and 38% versus 28%, respectively.

Men who took 5-ARIs were also significantly more likely to have clinically node positive and clinically metastatic disease at presentation, and have higher baseline levels of prostate-specific antigen (PSA).

And the risks for prostate-cancer specific mortality and all-cause mortality were significantly higher for 5-ARI users than nonusers, with subdistribution hazard ratios of 1.38 and 1.15, respectively.

“Our results suggest a need for increased awareness of 5-ARI–induced PSA suppression, clearer guidelines for early [prostate cancer] detection, and systems-based mechanisms to help improve care for men using 5-ARIs,” Rose et al conclude in JAMA Network Open.

By Shreeya Nanda

medwireNews is an independent medical news service provided by Springer Healthcare. © 2019 Springer Healthcare part of the Springer Nature group

JAMA Netw Open 2019; 2: e1913612