Men receiving 5α-reductase inhibitors for long-term treatment of benign prostatic hyperplasia have an increased risk for new-onset type 2 diabetes mellitus, a study published online in The BMJ has warned.
Li Wei, from University College London, and colleagues conducted a population-based study to examine the incidence of new-onset type 2 diabetes mellitus in men receiving steroid 5α-reductase inhibitors for benign prostatic hyperplasia.
Researchers assessed a total of 8,231, 30,774, and 16,270 men from the U.K. Clinical Practice Research Datalink (CPRD) and 1,251, 4,194, and 86,263 men from the Taiwanese National Health Insurance Research Database (NHIRD) who were receiving dutasteride, finasteride, and tamsulosin, respectively.
During a mean follow-up of 5.2 years, the researchers found 2,081 new-onset type 2 diabetes events in the CPRD. The event rate was 76.2, 76.6, and 60.3 per 10,000 person-years for dutasteride, finasteride, and tamsulosin, respectively. Compared with tamsulosin, the risk for type 2 diabetes was increased for dutasteride and finasteride (adjusted hazard ratios, 1.32 and 1.26, respectively).
The results for the NHIRD were consistent with these results with adjusted hazard ratios of 1.34 and 1.49 for dutasteride and finasteride versus tamsulosin. Similar results were seen in propensity score-matched analyses.
“In the light of our findings,” the authors concluded, “the decision to prescribe 5α-reductase inhibitors for men with metabolic disease must be considered carefully in the context of other risk factors for type 2 diabetes.”
REFERENCE: Wei et al: Incidence of type 2 diabetes mellitus in men receiving steroid 5α-reductase inhibitors: population based cohort study; https://www.bmj.com/content/365/bmj.l1204