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The Cardiovascular Safety of Dutasteride

2016; Lippincott Williams & Wilkins; Volume: 197; Issue: 5 Linguagem: Inglês

10.1016/j.juro.2016.11.082

1527-3792

Sean Skeldon, Erin M. Macdonald, Michael R. Law, Anjie Huang, J. Michael Paterson, Muhammad Mamdani, David N. Juurlink,

Pharmacology and Obesity Treatment

No AccessJournal of UrologyAdult Urology1 May 2017The Cardiovascular Safety of Dutasteride Sean C. Skeldon, Erin M. Macdonald, Michael R. Law, Anjie Huang, J. Michael Paterson, Muhammad M. Mamdani, and David Juurlink Sean C. SkeldonSean C. Skeldon More articles by this author , Erin M. MacdonaldErin M. Macdonald More articles by this author , Michael R. LawMichael R. Law More articles by this author , Anjie HuangAnjie Huang More articles by this author , J. Michael PatersonJ. Michael Paterson More articles by this author , Muhammad M. MamdaniMuhammad M. Mamdani Financial interest and/or other relationship with Astra Zeneca, Bristol-Myers Squibb, Eli Lilly and Company, Glaxo Smith Kline, Hoffman La Roche, Merck, Novartis, Novo Nordisk and Pfizer. More articles by this author , and David JuurlinkDavid Juurlink More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.11.082AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Randomized controlled trials suggest an increased risk of heart failure with dutasteride, which inhibits both the type 1 and type 2 isoforms of 5α-reductase. In contrast, no such association has been suggested for finasteride, which selectively inhibits the type 2 isoform. We investigated the risk of cardiovascular events among patients receiving dutasteride relative to finasteride. Materials and Methods: We performed a population based cohort study of Ontario men 66 years old or older who commenced treatment with dutasteride or finasteride between October 1, 2005 and March 31, 2015. For each individual treated with dutasteride, we identified 1 treated with finasteride, matching on a propensity score and calendar quarter of treatment initiation to account for temporal changes in prescribing. The primary outcome was hospitalization for heart failure. Secondary analyses were done to examine acute myocardial infarction and stroke. Cox proportional hazards regression was used to adjust for differences between groups. Results: We studied 36,311 men who commenced dutasteride and 36,311 treated with finasteride. In the primary analysis, we found no difference in the risk of heart failure among patients receiving dutasteride relative to those receiving finasteride (adjusted HR 0.98, 95% CI 0.88–1.08). Similarly, we found no difference in the risk of acute myocardial infarction (HR 0.94, 95% CI 0.82–1.08) or stroke (HR 1.03, 95% CI 0.88–1.20). 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Volume 197Issue 5May 2017Page: 1309-1314Supplementary Materials Advertisement Copyright & Permissions© 2017 by American Urological Association Education and Research, Inc.Keywordsheart failurefinasterideprostatic hyperplasiadrug-related side effects and adverse reactionsdutasterideMetricsAuthor Information Sean C. Skeldon More articles by this author Erin M. Macdonald More articles by this author Michael R. Law More articles by this author Anjie Huang More articles by this author J. Michael Paterson More articles by this author Muhammad M. Mamdani Financial interest and/or other relationship with Astra Zeneca, Bristol-Myers Squibb, Eli Lilly and Company, Glaxo Smith Kline, Hoffman La Roche, Merck, Novartis, Novo Nordisk and Pfizer. More articles by this author David Juurlink More articles by this author Expand All Advertisement PDF downloadLoading ...