Suicide and Intentional Self-harm Among Older Men Treated With 5-Alpha Reductase Inhibitor or Alpha-blockers for Benign Prostatic Hyperplasia.
Urology
; 192: 111-118, 2024 Oct.
Article
em En
| MEDLINE
| ID: mdl-38880345
ABSTRACT
OBJECTIVE:
To compare the risk of intentional self-harm (ISH) and suicide in older men using 5-α reductase inhibitors (5-ARIs) and alpha-blockers for benign prostatic hyperplasia (BPH). Observational research of older men with BPH suggested an increase in ISH with 5-ARI use compared with nonuse; we aimed to address potential confounding by indication with an active comparator reference group.METHODS:
Using Medicare data linked to the National Death Index (NDI) from 2007-2016, we implemented a retrospective cohort design in males aged ≥65 years who initiated 5-ARI or alpha-blocker use for BPH. ISH was identified using ICD-9-CM and ICD-10-CM diagnosis codes. Suicides were identified through cause-of-death information from the NDI. We used inverse probability of treatment weighted Cox proportional hazards regression to compare time-to-event between treatment groups, with robust variance estimation.RESULTS:
The event rates for ISH and suicide, respectively, were 0.314 and 0.308 per 1000 person-years (PY) among 5-ARI users (n = 181,675), and 0.364 and 0.382 per 1000PY among alpha-blocker users (n = 850,476). For 5-ARI use relative to alpha-blocker use, hazard ratios (HRs) for ISH and suicide, respectively, were 0.88 (95% CI0.62-1.25) and 0.82 (95% CI0.54-1.24); for the composite outcome (non-fatal ISH or suicide), the HR was 0.88 (95% CI0.66-1.16). Subgroup and sensitivity analyses supported these results.CONCLUSION:
5-ARI use was not associated with an increased risk for ISH or suicide compared to alpha-blocker use in older men with BPH. Study limitations included low event rates and potentially low sensitivity for ISH events.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Hiperplasia Prostática
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Suicídio
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Comportamento Autodestrutivo
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Antagonistas Adrenérgicos alfa
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Inibidores de 5-alfa Redutase
Limite:
Aged
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Aged80
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Humans
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Male
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Urology
Ano de publicação:
2024
Tipo de documento:
Article