Mp68-09 the Association Between 5-Alpha Reductase Inhibitors and Prostate Cancer Mortality

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History II (MP68)1 May 2024MP68-09 THE ASSOCIATION BETWEEN 5-ALPHA REDUCTASE INHIBITORS AND PROSTATE CANCER MORTALITY Robert J. Hamilton, Julian Chavarriaga, Najia Khurram, Cindy Lau, Jin Luo, Ning Liu, Maria Komisarenko, Girish Kulkarni, Cristopher Wallis, Neil Fleshner, and Antonio Finelli Robert J. HamiltonRobert J. Hamilton , Julian ChavarriagaJulian Chavarriaga , Najia KhurramNajia Khurram , Cindy LauCindy Lau , Jin LuoJin Luo , Ning LiuNing Liu , Maria KomisarenkoMaria Komisarenko , Girish KulkarniGirish Kulkarni , Cristopher WallisCristopher Wallis , Neil FleshnerNeil Fleshner , and Antonio FinelliAntonio Finelli View All Author Informationhttps://doi.org/10.1097/01.JU.0001008744.60568.e8.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: 5-alpha-reductase-inhibitors (5-ARIs), finasteride and dutasteride, are approved for treating benign prostatic hyperplasia (BPH), and reduce prostate cancer risk by 25%. However, trials also showed 5-ARI use to be associated with developing high-grade prostate cancer (PCa). Whether 5-ARIs may increase mortality among those diagnosed with prostate cancer remains unclear. Our aim was to study the long-term outcomes of clinically localized prostate cancer arising in men on 5-ARIs as compared to nonusers in a population-based cohort. METHODS: Men older than 65 years who developed PCa were studied using Ontario health care administrative databases with complete pathological abstraction. Our primary analysis assessed the association between 5-ARI use prior to prostate cancer diagnosis and all-cause and prostate cancer-specific mortality. Cox proportional hazard models with inverse probability treatment weights (IPTW) were used adjusting for prognostic covariates (age, income quintile, rurality, stage, morphology type, laterality, PSA, total Gleason score, total number of positive cores, maximum percent core, primary treatment, prior statin, post-treatment statin, prior metformin, post-treatment metformin). Sensitivity analyses based on cumulative pre-diagnostic 5-ARI use, Gleason score, comorbidity, 5-ARI indication, PSA modelling and statin use were also performed. RESULTS: From 2003 through 2015, we studied 19,938 patients with PCa with available pathology, and complete variables of interest. Of these, 2,112 (10.6%) were 5-ARI users and 17,826 (89.4%) were non-users before PCa diagnosis. During a median follow-up of 8.96 years (IQR 6.28-12.17), 6053 (30.36%) died, and 1047 died (5.25%) from PCa. After IPTW, 5-ARI use was not associated with overall survival: HR 0.98 95% CI 0.90-1.07, p=0.767 or PCa-specific survival: HR 1.02 95% CI 0.83-1.25 p=0.844. Subgroup analyses confirmed 5-ARI use remained not significantly associated with overall or PCa-specific survival. CONCLUSIONS: In our large population-based study, pre-diagnostic 5-ARI use was not associated with PCa-specific mortality or all-cause mortality. These data offer reassuring safety data for patients using 5-ARI for both benign and chemopreventive reasons. Download PPT Source of Funding: Canadian Urological Association Scholarship Fund © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1111 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Robert J. Hamilton More articles by this author Julian Chavarriaga More articles by this author Najia Khurram More articles by this author Cindy Lau More articles by this author Jin Luo More articles by this author Ning Liu More articles by this author Maria Komisarenko More articles by this author Girish Kulkarni More articles by this author Cristopher Wallis More articles by this author Neil Fleshner More articles by this author Antonio Finelli More articles by this author Expand All Advertisement PDF downloadLoading ...