Abstract
Abstract
Background:
Chronic inflammation is important in the development of benign prostatic hyperplasia (BPH), and certain oral antidiabetic medications have anti-inflammatory properties. The purpose of this study was to determine if use of thiazolidinediones or metformin was associated with a reduced risk of requiring medical or surgical treatment for BPH compared with the use of sulfonylureas among diabetic men.
Methods:
We constructed a retrospective cohort of 192,457 male veterans newly prescribed either rosiglitazone, pioglitazone, metformin, or a sulfonylurea. We used Cox proportional hazard regression to assess the association between use of a thiazolidinedione or metformin and the risk of requiring medical or surgical treatment for BPH compared with sulfonylurea use. New BPH treatment was defined by either a new prescription for an α-1 blocker or 5α-reductase inhibitors or a surgical procedure indicated for severe BPH.
Results:
In 259,995 person-years of follow-up we identified 14,690 new treatments for BPH. After adjusting for covariates including age, HbA1c, and body mass index, we found no association between rosiglitazone (adjusted hazard ratio [aHR] 1.02; 95% confidence interval [CI] 0.86, 1.20); pioglitazone (aHR 0.79; 95% CI 0.45, 1.38), or metformin use (aHR 0.99; 95% CI 0.94, 1.03) and risk of new medical or surgical treatment for BPH compared with sulfonylureas. Analyses ignoring prescriptions for nonselective α-1 blockers (terazosin, doxazosin, prazosin) from our BPH case definition (n=11,079) yielded similar results.
Conclusions:
In this large cohort, we observed no association between the use of thiazolidinediones or metformin and new medical or surgical treatment for BPH compared with sulfonylureas.
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Supplementary Material
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