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Prostate-selective α antagonists increase fracture risk in prostate cancer patients with and without a history of androgen deprivation therapy: a nationwide population-based study

INTRODUCTIONS: Prostate-selective α antagonists are recommended for relief of lower urinary tract symptoms in prostate cancer patients despite uncertainty of fracture risk as an addition to androgen deprivation therapy (ADT). The purpose of this study is to estimate fracture risk associated with the...

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Autores principales: Kao, Wei-Heng, Kuo, Chang-Fu, Chou, I-Jun, See, Lai-Chu, Huang, Wen-Kuan, Chiou, Meng-Jiun, Zhang, Weiya, Doherty, Michael, Wang, Chun-Chieh, Hsu, Jun-Te, Chen, Hsien-Hsin, Hong, Ji-Hong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Impact Journals LLC 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5797048/
https://www.ncbi.nlm.nih.gov/pubmed/29435177
http://dx.doi.org/10.18632/oncotarget.23828
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author Kao, Wei-Heng
Kuo, Chang-Fu
Chou, I-Jun
See, Lai-Chu
Huang, Wen-Kuan
Chiou, Meng-Jiun
Zhang, Weiya
Doherty, Michael
Wang, Chun-Chieh
Hsu, Jun-Te
Chen, Hsien-Hsin
Hong, Ji-Hong
author_facet Kao, Wei-Heng
Kuo, Chang-Fu
Chou, I-Jun
See, Lai-Chu
Huang, Wen-Kuan
Chiou, Meng-Jiun
Zhang, Weiya
Doherty, Michael
Wang, Chun-Chieh
Hsu, Jun-Te
Chen, Hsien-Hsin
Hong, Ji-Hong
author_sort Kao, Wei-Heng
collection PubMed
description INTRODUCTIONS: Prostate-selective α antagonists are recommended for relief of lower urinary tract symptoms in prostate cancer patients despite uncertainty of fracture risk as an addition to androgen deprivation therapy (ADT). The purpose of this study is to estimate fracture risk associated with these medications in prostate cancer patients who did and did not receive ADT. METHODS: The Taiwan National Health Insurance database was used to identify prostate cancer patients. We identified all 90-day person-quarters exposed to and not exposed to prostate-selective α antagonists. A generalized estimating equation model was used to estimated adjusted odd ratios (ORs) and 95% confidence intervals (CIs) for fracture associated with prostate-selective α antagonists with consideration for confounding by indication bias using propensity score. RESULTS: During 1997–2008, 16,601 persons received a diagnosis of prostate cancer, among whom 13,694 received ADT. Among prostate cancer patients receiving ADT, fracture was significantly more common in person-quarters with prostate-selective α antagonist use than in quarters without such treatment (OR, 1.08; 95% CI, 1.00–1.18). Prostate-selective α antagonist use was most strongly associated with femur fracture (OR, 1.22; 95% CI, 1.09–1.38), followed by skull fracture (OR, 1.29; 95% CIs: 0.93–1.80). Among patients who did not receive ADT, fracture was more common in person-quarters with prostate-selective α antagonist use than in those without medication use (OR, 1.19; 95% CI, 0.91–1.55). CONCLUSIONS: Prostate-selective α antagonist is associated with an increased fracture risk, particular for fractures in skull and femur. Patients should be well-informed on this potential risk before taking prostate-selective α antagonists.
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spelling pubmed-57970482018-02-12 Prostate-selective α antagonists increase fracture risk in prostate cancer patients with and without a history of androgen deprivation therapy: a nationwide population-based study Kao, Wei-Heng Kuo, Chang-Fu Chou, I-Jun See, Lai-Chu Huang, Wen-Kuan Chiou, Meng-Jiun Zhang, Weiya Doherty, Michael Wang, Chun-Chieh Hsu, Jun-Te Chen, Hsien-Hsin Hong, Ji-Hong Oncotarget Research Paper INTRODUCTIONS: Prostate-selective α antagonists are recommended for relief of lower urinary tract symptoms in prostate cancer patients despite uncertainty of fracture risk as an addition to androgen deprivation therapy (ADT). The purpose of this study is to estimate fracture risk associated with these medications in prostate cancer patients who did and did not receive ADT. METHODS: The Taiwan National Health Insurance database was used to identify prostate cancer patients. We identified all 90-day person-quarters exposed to and not exposed to prostate-selective α antagonists. A generalized estimating equation model was used to estimated adjusted odd ratios (ORs) and 95% confidence intervals (CIs) for fracture associated with prostate-selective α antagonists with consideration for confounding by indication bias using propensity score. RESULTS: During 1997–2008, 16,601 persons received a diagnosis of prostate cancer, among whom 13,694 received ADT. Among prostate cancer patients receiving ADT, fracture was significantly more common in person-quarters with prostate-selective α antagonist use than in quarters without such treatment (OR, 1.08; 95% CI, 1.00–1.18). Prostate-selective α antagonist use was most strongly associated with femur fracture (OR, 1.22; 95% CI, 1.09–1.38), followed by skull fracture (OR, 1.29; 95% CIs: 0.93–1.80). Among patients who did not receive ADT, fracture was more common in person-quarters with prostate-selective α antagonist use than in those without medication use (OR, 1.19; 95% CI, 0.91–1.55). CONCLUSIONS: Prostate-selective α antagonist is associated with an increased fracture risk, particular for fractures in skull and femur. Patients should be well-informed on this potential risk before taking prostate-selective α antagonists. Impact Journals LLC 2018-01-02 /pmc/articles/PMC5797048/ /pubmed/29435177 http://dx.doi.org/10.18632/oncotarget.23828 Text en Copyright: © 2018 Kao et al. http://creativecommons.org/licenses/by/3.0/ This article is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/) (CC-BY), which permits unrestricted use and redistribution provided that the original author and source are credited.
spellingShingle Research Paper
Kao, Wei-Heng
Kuo, Chang-Fu
Chou, I-Jun
See, Lai-Chu
Huang, Wen-Kuan
Chiou, Meng-Jiun
Zhang, Weiya
Doherty, Michael
Wang, Chun-Chieh
Hsu, Jun-Te
Chen, Hsien-Hsin
Hong, Ji-Hong
Prostate-selective α antagonists increase fracture risk in prostate cancer patients with and without a history of androgen deprivation therapy: a nationwide population-based study
title Prostate-selective α antagonists increase fracture risk in prostate cancer patients with and without a history of androgen deprivation therapy: a nationwide population-based study
title_full Prostate-selective α antagonists increase fracture risk in prostate cancer patients with and without a history of androgen deprivation therapy: a nationwide population-based study
title_fullStr Prostate-selective α antagonists increase fracture risk in prostate cancer patients with and without a history of androgen deprivation therapy: a nationwide population-based study
title_full_unstemmed Prostate-selective α antagonists increase fracture risk in prostate cancer patients with and without a history of androgen deprivation therapy: a nationwide population-based study
title_short Prostate-selective α antagonists increase fracture risk in prostate cancer patients with and without a history of androgen deprivation therapy: a nationwide population-based study
title_sort prostate-selective α antagonists increase fracture risk in prostate cancer patients with and without a history of androgen deprivation therapy: a nationwide population-based study
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5797048/
https://www.ncbi.nlm.nih.gov/pubmed/29435177
http://dx.doi.org/10.18632/oncotarget.23828
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