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Title: Finasteride Does Not Increase Hip Fracture Risk in Men With Enlarged Prostate
URL: http://www.pslgroup.com/dg/22E54E.htm
Doctor's Guide
October 7, 2008

CHICAGO -- October 7, 2008 -- Use of 5-alpha-reductase inhibitors for treating an enlarged prostate is not associated with an increased hip fracture risk, according to a study in the October 8 issue of the Journal of the American Medical Association.

Steven J. Jacobsen, MD, Kaiser Permanente Southern California, Pasadena, California, and colleagues examined the association between use of 5-alpha-reductase inhibitors for benign prostatic hyperplasia (BPH) and occurrence of hip fracture.

The study included 7,076 men, aged 45 years and older, who experienced a hip fracture between 1997 and 2006. Control patients were 7,076 men without a hip fracture during the study period.

Electronic information on pharmaceutical use was utilized to identify use of finasteride from 1991 forward. During this period (1991-2006), finasteride was the only 5-alpha-reductase inhibitor dispensed to study patients. In addition, 109 case patients (1.5%) and 141 control patients (2%) had a history of any exposure to these compounds.

The researchers found that there was no dose-response relationship between exposure to 5-alpha-reductase inhibitors when the exposure was stratified into levels of total exposure. Of the patients in the study, 2,547 (36% with hip fracture) and 2,488 (35% without hip fracture) had a prior diagnosis of BPH. The use of alpha-blockers was slightly greater in men with hip fracture (32%) compared with those without hip fracture (30%).

"These data suggest that 5-[alpha]-reductase inhibitors do not confer a negative risk for bone health and in fact may lower the risk of hip fracture. While presumably this lower risk is related to hormonal mechanisms, further understanding of the biological mechanisms underlying this phenomenon may lead to new insights that can be exploited for preventive measures. The increased risk of fracture associated with recent receipt of an [alpha]-blocker highlights the need for careful [use] of these agents," the authors wrote.


SOURCE: Journal of the American Medical Association

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