POD-3 The association of new onset diabetes and medical therapy for benign prostatic hyperplasia
Saturday June 29, 2019 from 21:45 to 22:15
TBD
Presenter

Jeannette Johnstone, Canada

Resident

Department of Urology

Queen's Urology

Abstract

The association of new onset diabetes and medical therapy for benign prostatic hyperplasia

Jeannette Johnstone1, Avril J. Lusty3, D. Robert Siemens1,2, J. Curtis Nickel1, Mina Tohidi1, Marlo Whitehead2, Joan Tranmer1.

1Department of Urology, Queen's University, Kingston, ON, Canada; 2Department of Oncology, Queen's Urology, Kingston, ON, Canada; 3Department of Urology, University of Ottawa, Ottawa, ON, Canada

Introduction: Long-term medical management of benign prostatic hyperplasia (BPH) includes use of 5-alpha reductase inhibitors (5ARI) and alpha-blockers (AB).  Studies have demonstrated an increased risk of comorbidities, including cardiac failure and diabetes mellitus with use of these medications, raising safety concerns.  This study aims to determine the risk of developing diabetes with the use of AB and 5ARI in combination as well as monotherapy.  

Methods: This population-based study used administrative databases to look at men over the age of 66 with a diagnosis of BPH between 2005 and 2015.  Men were categorized based on exposure to 5ARI or AB.  Primary outcome was new cardiac failure and new diagnosis of diabetes.   Variables examined included exposure time to medication, age, and comorbidities and logistic regression was used for statistical analysis.

Results: There was a total 129 223 men with a BPH diagnosis and no prior history of diabetes mellitus.  Of these, 6 390 were exposed to 5ARI, 39 592 exposed to AB, and 30 545 exposed to combination therapy.    There was a statistically significant association with new onset of diabetes mellitus with these medication regimens compared to no medication use.  Men treated with combination therapy of 5ARI and AB (OR 1.276; 95% CI 1.226-1.329), 5ARI monotherapy (OR 1.254; 95% CI 1.168-1.345), or AB monotherapy (OR 1.171; 95% CI 1.127-1.217) all showed increased association.  When calculating risk of new diagnosis of diabetes measured from start of therapy, AB had a decreased risk in comparison to 5ARI monotherapy (OR 0.887; 95% CI 0.816-0.966).

Conclusions: In this study, men with a BPH diagnosis and exposed to both 5ARI and AB therapy had an increased association of developing new onset diabetes mellitus when compared to no medication use.  In a direct comparison of those that initiated monotherapy, 5ARI was shown to have an increased risk compared to AB.


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