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Randomized Controlled Trial
. 2016 Sep;196(3):715-20.
doi: 10.1016/j.juro.2016.03.172. Epub 2016 Apr 5.

The Association between Phosphodiesterase Type 5 Inhibitors and Prostate Cancer: Results from the REDUCE Study

Juzar Jamnagerwalla  1 , Lauren E Howard  2 , Adriana C Vidal  1 , Daniel M Moreira  3 , Ramiro Castro-Santamaria  4 , Gerald L Andriole  5 , Stephen J Freedland  6
Affiliations
Randomized Controlled Trial

The Association between Phosphodiesterase Type 5 Inhibitors and Prostate Cancer: Results from the REDUCE Study

Juzar Jamnagerwalla et al. J Urol. 2016 Sep.

Abstract

Purpose: Despite routine use of phosphodiesterase type 5 inhibitor to treat erectile dysfunction the role in prostate cancer chemoprevention remains unclear. Only a few studies have explored the link between phosphodiesterase type 5 inhibitor use and prostate cancer. We tested the association between phosphodiesterase type 5 inhibitor and prostate cancer risk in the REDUCE (Reduction by Dutasteride of Prostate Cancer Events) trial.

Materials and methods: REDUCE was a 4-year multicenter study testing the effect of daily dutasteride on prostate cancer risk in men with prostate specific antigen 2.5 to 10.0 ng/ml and negative biopsy who underwent study mandated biopsies at 2 and 4 years. The association of phosphodiesterase type 5 inhibitor with overall prostate cancer risk and disease grade (Gleason 2-6 and 7-10) was examined using adjusted logistic and multinomial regression analysis. Secondary analysis was performed to explore the association between phosphodiesterase type 5 inhibitor and prostate cancer risk in North American men, given the significantly higher use of phosphodiesterase type 5 inhibitor in these subjects.

Results: Phosphodiesterase type 5 inhibitor was not associated with prostate cancer diagnosis (OR 0.90, 95% CI 0.68-1.20, p = 0.476), low grade disease (OR 0.93, 95% CI 0.67-1.27, p = 0.632) or high grade disease (OR 0.85, 95% CI 0.51-1.39, p = 0.508). An inverse trend was seen between phosphodiesterase type 5 inhibitor and prostate cancer diagnosis in North American men but this was not statistically significant (OR 0.67, 95% CI 0.42-1.07, p = 0.091).

Conclusions: Phosphodiesterase type 5 inhibitor use was not associated with decreased prostate cancer diagnoses on post-hoc analysis of REDUCE. In North American men, who had much higher baseline use of phosphodiesterase type 5 inhibitor, this treatment was associated with an inverse trend of prostate cancer diagnosis that approached but did not reach statistical significance.

Keywords: chemoprevention; erectile dysfunction; phosphodiesterase 5 inhibitors; prostatic neoplasms; risk.

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Figures

Figure 1
Figure 1
Assembly of study population from REDUCE BMI = Body mass index, PC=prostate cancer; TRUS=transrectal ultrasound; PSA=prostate specific antigen; CAD = coronary artery disease; DRE=digital rectal exam
See this image and copyright information in PMC

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