Finasteride reduces the risk of incident clinical benign prostatic hyperplasia.
Finasteride reduces the risk of incident clinical benign prostatic hyperplasia.
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DOI：
10.1016/j.eururo.2012.03.007
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发表时间：
2012-08
期刊：
影响因子：
23.4
通讯作者：
Kristal, Alan R.
中科院分区：
文献类型：
--
作者：
Parsons, J. Kellogg;Schenk, Jeannette M.;Arnold, Kathryn B.;Messer, Karen;Till, Cathee;Thompson, Ian M.;Kristal, Alan R.
关键词：
尽管老年男性临床良性前列腺增生 (BPH) 的患病率很高，但仍明显缺乏针对 BPH 预防的研究。确定非那雄胺是否可以预防健康老年男性发生临床 BPH。这项研究的数据来自前列腺癌预防试验。排除有 BPH 诊断或治疗史或研究开始时国际前列腺症状评分 (IPSS) ≥8 的患者后，共有 9253 名男性可供分析。主要结局是临床 BPH 事件，定义为开始药物治疗、手术或持续的临床显着泌尿系统症状 (IPSS >14)。使用 Cox 比例回归模型生成风险比 (HR) 来估计非那雄胺的疗效。平均随访时间为 5.3 年。安慰剂组的临床 BPH 发生率为每 1000 人年 19 例，非那雄胺组的临床 BPH 发生率为每 1000 人年 11 例 (p < 0.001)。在协变量调整模型中，非那雄胺将临床 BPH 事件的风险降低了 40%（HR：0.60；95% 置信区间，0.51–0.69；p < 0.001）。在体重指数≥30 kg/m2（pinteraction = 0.04）的男性中，非那雄胺对临床 BPH 的影响减弱，但在身体活动、年龄、种族、当前糖尿病或当前吸烟方面没有显着差异。分析的事后性质是一个潜在的研究限制。非那雄胺可显着降低健康老年男性发生临床 BPH 的风险。在制定使用非那雄胺预防无症状老年男性前列腺疾病的建议时应考虑这些结果。
Despite the high prevalence of clinical benign prostatic hyperplasia (BPH) among older men, there remains a notable absence of studies focused on BPH prevention. To determine if finasteride prevents incident clinical BPH in healthy older men. Data for this study are from the Prostate Cancer Prevention Trial. After excluding those with a history of BPH diagnosis or treatment, or an International Prostate Symptom Score (IPSS) ≥8 at study entry, 9253 men were available for analysis. The primary outcome was incident clinical BPH, defined as the initiation of medical treatment, surgery, or sustained, clinically significant urinary symptoms (IPSS >14). Finasteride efficacy was estimated using Cox proportional regression models to generate hazards ratios (HRs). Mean length of follow-up was 5.3 yr. The rate of clinical BPH was 19 per 1000 person-years in the placebo arm and 11 per 1000 person-years in the finasteride arm (p < 0.001). In a covariate-adjusted model, finasteride reduced the risk of incident clinical BPH by 40% (HR: 0.60; 95% confidence interval, 0.51–0.69; p < 0.001). The effect of finasteride on incident clinical BPH was attenuated in men with a body mass index ≥30 kg/m2 (pinteraction = 0.04) but otherwise did not differ significantly by physical activity, age, race, current diabetes, or current smoking. The post hoc nature of the analysis is a potential study limitation. Finasteride substantially reduces the risk of incident clinical BPH in healthy older men. These results should be considered in formulating recommendations for the use of finasteride to prevent prostate diseases in asymptomatic older men.
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