Department of Urology, S.Pio Da Pietrelcina Hospital, via Anelli, 82, 66054, Vasto, Italy.
World J Urol. 2013 Jun;31(3):665-71. doi: 10.1007/s00345-012-1000-4. Epub 2012 Dec 14.
To investigate differences in the risk of benign prostatic hyperplasia (BPH)-related hospitalization, for surgical and non-surgical reasons, and of new prostate cancer (PCa) diagnosis between patients using finasteride or dutasteride.
A retrospective cohort study was conducted using data from record linkage of administrative databases (pharmaceutical prescription data, hospital discharge records, Italian population registry). Men aged ≥ 40 years old who had received a prescription for at least 10 packs/year between January 1, 2004 and December 31, 2004 were included and followed for 5 years. The association of the outcomes was assessed using a multiple Cox proportional hazard model. Propensity score-matched analysis and a 5-1, greedy 1:1 matching algorithm were performed.
8,132 patients were identified. Overall incidence rates of BPH hospitalization and BPH-related surgery were 21.05 (95 % CI 19.52-22.71) and 20.97 (95 % CI 19.45-22.61) per 1,000 person-years, respectively. In the dutasteride group compared with finasteride group, the incidence rate of both events was statistically significant lower: 16.07 versus 21.76 for BPH hospitalization and 15.91 versus 21.69 for BPH-related surgery. The incidence rate of new PCa was also lower for the dutasteride group [8.34 (95 % CI 5.96-11.68) vs. 10.25 (95 % CI 9.15-11.49)]. Dutasteride was associated with a reduction in BPH-related hospitalizations (HR 0.75, 95 % CI 0.58-0.98 and 0.58-0.98 for surgical and non-surgical reasons). The matched analysis confirmed the risk reduction with dutasteride for BPH-related surgery.
These findings suggest that the clinical effects of dutasteride and finasteride might be different. Patients treated with dutasteride seem to be less likely to experience BPH-related hospitalization. Comparative studies are needed to confirm these results.
研究使用非那雄胺或度他雄胺的患者之间因良性前列腺增生（BPH）相关住院治疗（手术和非手术原因）和新发前列腺癌（PCa）诊断的风险差异。
本研究采用回顾性队列研究，对来自记录链接的行政数据库（药物处方数据、住院记录、意大利人口登记处）的数据进行分析。纳入年龄≥40 岁，在 2004 年 1 月 1 日至 12 月 31 日期间至少接受 10 包/年处方的患者，并随访 5 年。使用多 Cox 比例风险模型评估结局的相关性。进行倾向评分匹配分析和 5-1、贪婪 1:1 匹配算法。
共纳入 8132 例患者。BPH 住院和 BPH 相关手术的总体发生率分别为 21.05（95%CI 19.52-22.71）和 20.97（95%CI 19.45-22.61）/1000 人年。与非那雄胺组相比，度他雄胺组这两种事件的发生率均显著降低：BPH 住院为 16.07% vs. 21.76%，BPH 相关手术为 15.91% vs. 21.69%。度他雄胺组新发 PCa 的发生率也较低[8.34（95%CI 5.96-11.68）vs. 10.25（95%CI 9.15-11.49）]。度他雄胺与 BPH 相关住院治疗的风险降低相关（HR 0.75，95%CI 0.58-0.98 和 0.58-0.98，分别用于手术和非手术原因）。匹配分析证实了度他雄胺对 BPH 相关手术的风险降低作用。
这些发现表明非那雄胺和度他雄胺的临床效果可能不同。使用度他雄胺治疗的患者发生 BPH 相关住院治疗的可能性较低。需要进行比较研究来证实这些结果。
