5 alpha reductase inhibitors and mortality risk in men with benign prostatic hyperplasia

This study compared mortality (risk of death) in men with benign prostatic hyperplasia being treated with either 5 alpha reductase inhibitors (5ARI) or alpha blockers (AB). This study concluded that there was no increased risk with 5ARI versus AB treatment.

Benign Prostatic Hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland. An enlarged prostate can affect bladder function and have a negative impact on quality of life. Treatments for BPH may include medication or surgery. Medications for BPH often result in many side effects while surgery can lead to complications.

5ARI may stop prostate growth. They do this through stopping a male sex hormone being made. AB drugs relax the muscles in the prostate and the bladder neck, improving urine flow and decreasing bladder blockage.

174,895 men who had benign prostatic hyperplasia or lower urinary tract symptoms were followed for one year. The men were ≥ 50 years old. Men on either AB or 5ARI were matched based on race, when they began to have bladder symptoms, whether they had used alpha blockers before, and their region. Mortality was measured through examining death records and databases for the particular regions.

During the study, approximately 19% of 5ARI users and 20% of AB users died. When the differences between age, race, region, beginning of drug treatment, history of AB treatment and comorbidities were taken into account, patients taking 5ARI were not at an increased risk of death versus patients taking AB.

This study concluded that BPH or lower urinary symptom treatment in men with 5ARI shows no increased mortality risk when compared with treatment with AB.

The authors note that 5ARI can increase the risk of high grade prostate cancer. The authors also note that some patients were taking 5ARI in combination with another drug and this may have affected results.

If you are interested in treating your benign prostatic hyperplasia or lower urinary symptoms with 5ARI, contact your doctor.