The effects of dutasteride and finasteride on BPH-related hospitalization, surgery and prostate cancer diagnosis: a record-linkage analysis
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To investigate differences in the risk of benign prostatic hyperplasia (BPH)-related hospitalization, for surgical and non-surgical reasons, and of new prostate cancer (PCa) diagnosis between patients using finasteride or dutasteride.
A retrospective cohort study was conducted using data from record linkage of administrative databases (pharmaceutical prescription data, hospital discharge records, Italian population registry). Men aged ≥40 years old who had received a prescription for at least 10 packs/year between January 1, 2004 and December 31, 2004 were included and followed for 5 years.
The association of the outcomes was assessed using a multiple Cox proportional hazard model. Propensity score-matched analysis and a 5–1, greedy 1:1 matching algorithm were performed.
8,132 patients were identified. Overall incidence rates of BPH hospitalization and BPH-related surgery were 21.05 (95 % CI 19.52–22.71) and 20.97 (95 % CI 19.45–22.61) per 1,000 person-years, respectively. In the dutasteride group compared with finasteride group, the incidence rate of both events was statistically significant lower: 16.07 versus 21.76 for BPH hospitalization and 15.91 versus 21.69 for BPH-related surgery. The incidence rate of new PCa was also lower for the dutasteride group [8.34 (95 % CI 5.96–11.68) vs. 10.25 (95 % CI 9.15–11.49)]. Dutasteride was associated with a reduction in BPH-related hospitalizations (HR 0.75, 95 % CI 0.58–0.98 and 0.58–0.98 for surgical and non-surgical reasons). The matched analysis confirmed the risk reduction with dutasteride for BPH-related surgery.
These findings suggest that the clinical effects of dutasteride and finasteride might be different. Patients treated with dutasteride seem to be less likely to experience BPH-related hospitalization. Comparative studies are needed to confirm these results.
KeywordsBenign prostatic hyperplasia (BPH) Dutasteride Finasteride Epidemiology Medical record linkage
This study was financially supported by an unconditional grant from GlaxoSmithKline.
Conflict of interest
The authors declare that they have no conflict of interest.
- 2.Oelke M, Bachmann A, Descazeaud A,et al. Guidelines on Management of Male Lower Urinary Tract Symptoms (LUTS), incl. Benign Prostatic Obstruction (BPO) Uroweb 2012. Accessed 21 June 2012 at http://www.uroweb.org/gls/pdf/12_Male_LUTS_LR%20May%209th%202012.pdf
- 4.McConnell JD, Roehrborn CG, Bautista O et al (2003) Medical therapy of prostatic symptoms (MTOPS) research group. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med 349:2387–2398PubMedCrossRefGoogle Scholar
- 17.WHO Collaborating Centre for Drug Statistics Methodology (2003) ATC Index with DDDs. WHO, Oslo, NorwayGoogle Scholar
- 18.US Centers for Disease Control and Prevention. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). http://www.cdc.gov/nchs/icd/icd9cm.htm. Accessibility verified 14 May 2012
- 26.Parsons LS (2004) Reducing bias in a propensity score matched pair sample using greedy matching techniques. Proceedings of the Twenty-Sixth Annual SAS Users Group International Conference. SAS Institute, Cary, NC, InGoogle Scholar
- 29.McConnell JD, Bruskewitz R, Walsh P et al (1998) The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. finasteride long-term efficacy and safety study group. N Engl J Med 338:557–563PubMedCrossRefGoogle Scholar