Prostate Cancer Risk and Prognostic Influence Among Users of 5-Alpha-Reductase Inhibitors and Alpha-Blockers: A Systematic Review and Meta-Analysis

Yougen Wu; Yang Wang; Yuting Gu; Ju Xia; Qingqing Qian; Yang Hong

doi:10.1016/j.urology.2020.05.105

Prostate Cancer Risk and Prognostic Influence Among Users of 5-Alpha-Reductase Inhibitors and Alpha-Blockers: A Systematic Review and Meta-Analysis

Urology. 2020 Nov:145:216-223. doi: 10.1016/j.urology.2020.05.105. Epub 2020 Jul 31.

Authors

Yougen Wu¹, Yang Wang², Yuting Gu³, Ju Xia³, Qingqing Qian⁴, Yang Hong⁵

Affiliations

¹ National Institute of Clinical Research, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China. Electronic address: [email protected].
² Department of Urology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China.
³ National Institute of Clinical Research, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China.
⁴ National Institute of Clinical Research, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China; Department of Pharmacy, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China.
⁵ National Institute of Clinical Research, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China; Department of Osteology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China.

PMID: 32745485
DOI: 10.1016/j.urology.2020.05.105

Abstract

We systematically assessed the effect of 5-alpha-reductase inhibitors (5-ARIs) and/or alpha-blockers use on prostate cancer (CaP) incidence and outcomes, including CaP pathologic progression, CaP-specific mortality, and all-cause mortality. 5-ARIs but not alpha-blockers decreased risk of overall CaP, low grade CaP (Gleason < 7), and delayed CaP pathologic progression. Both 5-ARIs and alpha-blockers had no significant impact on risk of high grade CaP (Gleason ≥ 7), CaP-specific mortality, or all-cause mortality. Our result suggested that finasteride should be given for at least 4 years if used for preventing CaP.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

5-alpha Reductase Inhibitors / therapeutic use*
Adrenergic alpha-Antagonists / therapeutic use*
Humans
Incidence
Male
Prognosis
Prostatic Neoplasms / epidemiology*
Prostatic Neoplasms / prevention & control*
Risk Assessment
Treatment Outcome

Substances

5-alpha Reductase Inhibitors
Adrenergic alpha-Antagonists