Do Prostate Drugs Harm Bones?
Study: 1 Class of Drugs for Enlarged Prostate Does Not Increase Risk of Hip Fractures
By
Kelley Colihan
WebMD Health News
Reviewed By
Louise Chang, MD
Oct. 7, 2008 -- Millions of men suffer from an enlarged prostate gland. There
are many drugs available for treatment, but what effects do these drugs have on bone health?
Researchers estimate that more than 8 million men in the U.S. ages 50-79
will have to deal with an enlarged prostate by the year 2010.
Drugs that treat enlarged prostate, or benign prostatic hyperplasia (BPH),
come in two groups: 5-alpha reductase inhibitors and alpha-blockers.
Researchers led by Steven J. Jacobsen, MD, of Kaiser Permanente Southern
California, wanted to find out if there is any connection between 5-alpha
reductase inhibitors and hip fractures. Examples of these
drugs include Proscar and Avodart.
These drugs treat BPH in part by blocking testosterone from converting to
dihydrotestosterone. The researchers write that other studies "suggest that
dihydrotestosterone might have a role in bone metabolism, but no clear evidence
exists to support this theory."
The researchers gathered data on 7,076 men (45 years and older) from 1997 to
2006, all who had hip fractures. They compared them with a group of 7,076
similar men who did not have a hip fracture.
A similar percentage of men in each group had benign prostatic
hyperplasia.
The researchers found:
- 109 of the men with hip fractures had taken a 5-alpha reductase
inhibitor
- 141 of the men without hip fractures had taken a 5-alpha reductase
inhibitor
Their conclusion: 5-alpha reductase inhibitors are not linked to an
increased risk of hip fracture; instead, they may decrease risk of hip
fracture.
Interestingly, the researchers also found a modest increase in hip fracture
risk in the men who took alpha-blockers. There was more use of alpha-blockers
(32%) in men with hip fractures vs. men without hip fractures (30%). Since this
was not a primary focus of the study, the researchers write that this finding
warrants further investigation.
Alpha-blockers include Flomax, Uroxatral, Cardura, and
Hytrin.
WebMD phoned the trade organization PhMRA for reaction, but they said their
policy is not to comment on these types of studies regarding classes of drugs
or individual drugmakers.
The researchers note that they only studied older men and that more research
should be done on the long-term risks of these drugs in younger men.
The study appears in the Oct. 8 issue of The Journal of the American
Medical Association.
SOURCES: Jacobsen, S. The Journal of the American Medical Association, Oct. 8,
2008; vol 300: pp 1660-1664. News release, The Journal of the American Medical Association.
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