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Tamsulosin and the risk of dementia in older men with benign prostatic hyperplasia.
Pharmacoepidemiol Drug Saf. 2018 03; 27(3):340-348.PD

Abstract

PURPOSE

Clinicians use tamsulosin, an α1-adrenoceptor antagonist, to manage symptomatic benign prostatic hyperplasia (BPH). Because α1-adrenoceptors are also present in the brain, the potential exists for adverse effects on cognitive functions. We explored the association between tamsulosin use and dementia risk.

METHODS

We used Medicare data (2006-2012) to conduct a cohort study among patients aged ≥65 years and diagnosed with BPH. Men taking tamsulosin (n = 253 136) were matched at a 1:1 ratio using propensity-scores to each of 6 comparison cohorts: patients who used no BPH-medication (n = 180 926), and patients who used the following alternative-BPH-medications: doxazosin (n = 28 581), terazosin (n = 23 858), alfuzosin (n = 17 934), dutasteride (n = 34 027), and finasteride (n = 38 767). Assessment began following the first fill of BPH-medication to identify incident dementia by ICD-9 diagnosis codes. We estimated hazard ratios (HR) and 95% confidence intervals (CI) for dementia using Cox proportional hazard regression for each of the 6 propensity-score-matched cohort-pairs.

RESULTS

The median follow-up period for all cohorts was 19.8 months. After propensity-score matching, the tamsulosin cohort had an incidence of dementia of 31.3/1000 person-years compared with only 25.9/1000 person-years in the no-BPH-medication cohort. The risk of dementia was significantly higher in the tamsulosin cohort, when compared with the no-BPH-medication cohort (HR [95% CI]: 1.17 [1.14, 1.21]) and each of the alternative-BPH-medication cohorts: doxazosin (1.20 [1.12, 1.28]), terazosin (1.11 [1.04, 1.19]), alfuzosin (1.12 [1.03, 1.22]), dutasteride (1.26 [1.19, 1.34]), and finasteride (1.13 [1.07, 1.19]). The significance of these findings persisted in sensitivity analyses.

CONCLUSION

Tamsulosin may increase the risk of dementia in older men with BPH.

Authors+Show Affiliations

Department of Community Medicine and Health Care, University of Connecticut Health Center, Farmington, CT, USA. Connecticut Institute for Clinical and Translational Science (CICATS), Farmington, CT, USA.Department of Community Medicine and Health Care, University of Connecticut Health Center, Farmington, CT, USA. Connecticut Institute for Clinical and Translational Science (CICATS), Farmington, CT, USA.Department of Surgery (Urology), University of Connecticut Health Center, Farmington, CT, USA.Connecticut Institute for Clinical and Translational Science (CICATS), Farmington, CT, USA. Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA.

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29316005

Citation

Duan, Yinghui, et al. "Tamsulosin and the Risk of Dementia in Older Men With Benign Prostatic Hyperplasia." Pharmacoepidemiology and Drug Safety, vol. 27, no. 3, 2018, pp. 340-348.
Duan Y, Grady JJ, Albertsen PC, et al. Tamsulosin and the risk of dementia in older men with benign prostatic hyperplasia. Pharmacoepidemiol Drug Saf. 2018;27(3):340-348.
Duan, Y., Grady, J. J., Albertsen, P. C., & Helen Wu, Z. (2018). Tamsulosin and the risk of dementia in older men with benign prostatic hyperplasia. Pharmacoepidemiology and Drug Safety, 27(3), 340-348. https://doi.org/10.1002/pds.4361
Duan Y, et al. Tamsulosin and the Risk of Dementia in Older Men With Benign Prostatic Hyperplasia. Pharmacoepidemiol Drug Saf. 2018;27(3):340-348. PubMed PMID: 29316005.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tamsulosin and the risk of dementia in older men with benign prostatic hyperplasia. AU - Duan,Yinghui, AU - Grady,James J, AU - Albertsen,Peter C, AU - Helen Wu,Z, Y1 - 2018/01/09/ PY - 2016/09/27/received PY - 2017/10/23/revised PY - 2017/10/25/accepted PY - 2018/1/10/pubmed PY - 2019/9/10/medline PY - 2018/1/10/entrez KW - benign prostatic hyperplasia KW - claims database KW - dementia KW - pharmacoepidemiology KW - propensity score matching KW - retrospective cohort study KW - tamsulosin SP - 340 EP - 348 JF - Pharmacoepidemiology and drug safety JO - Pharmacoepidemiol Drug Saf VL - 27 IS - 3 N2 - PURPOSE: Clinicians use tamsulosin, an α1-adrenoceptor antagonist, to manage symptomatic benign prostatic hyperplasia (BPH). Because α1-adrenoceptors are also present in the brain, the potential exists for adverse effects on cognitive functions. We explored the association between tamsulosin use and dementia risk. METHODS: We used Medicare data (2006-2012) to conduct a cohort study among patients aged ≥65 years and diagnosed with BPH. Men taking tamsulosin (n = 253 136) were matched at a 1:1 ratio using propensity-scores to each of 6 comparison cohorts: patients who used no BPH-medication (n = 180 926), and patients who used the following alternative-BPH-medications: doxazosin (n = 28 581), terazosin (n = 23 858), alfuzosin (n = 17 934), dutasteride (n = 34 027), and finasteride (n = 38 767). Assessment began following the first fill of BPH-medication to identify incident dementia by ICD-9 diagnosis codes. We estimated hazard ratios (HR) and 95% confidence intervals (CI) for dementia using Cox proportional hazard regression for each of the 6 propensity-score-matched cohort-pairs. RESULTS: The median follow-up period for all cohorts was 19.8 months. After propensity-score matching, the tamsulosin cohort had an incidence of dementia of 31.3/1000 person-years compared with only 25.9/1000 person-years in the no-BPH-medication cohort. The risk of dementia was significantly higher in the tamsulosin cohort, when compared with the no-BPH-medication cohort (HR [95% CI]: 1.17 [1.14, 1.21]) and each of the alternative-BPH-medication cohorts: doxazosin (1.20 [1.12, 1.28]), terazosin (1.11 [1.04, 1.19]), alfuzosin (1.12 [1.03, 1.22]), dutasteride (1.26 [1.19, 1.34]), and finasteride (1.13 [1.07, 1.19]). The significance of these findings persisted in sensitivity analyses. CONCLUSION: Tamsulosin may increase the risk of dementia in older men with BPH. SN - 1099-1557 UR - https://www.unboundmedicine.com/medline/citation/29316005/Tamsulosin_and_the_risk_of_dementia_in_older_men_with_benign_prostatic_hyperplasia_ L2 - https://doi.org/10.1002/pds.4361 DB - PRIME DP - Unbound Medicine ER -