Treatment with an α1adrenoceptor antagonist, tamsulosin, is associated with increased dementia risk among patients with symptomatic benign prostatic hyperplasia (BPH) aged ≥65 years, according to a Medicare data analysis published in Pharmacoepidemiology Drug Safety.
Using Medicare data from 2006 to 2012, investigators obtained patient data for men ≥65 years who were actively taking tamsulosin (n=253,136). These patients were compared with propensity-score-matched patients who did not use BPH medications (n=180,926), as well as patients who used doxazosin (n=28,581), terazosin (n=23,858), alfuzosin (n=17,934), dutasteride (n=34,027), and finasteride (n=38,767). Investigators used International Classification of Diseases, Ninth Revision, diagnosis codes to determine and compare incident dementia rates between each group.
A greater number of men in the tamsulosin group had dementia at the median 19.8-month follow-up compared with men who were not taking BPH medications (31.3 vs 25.9 per 1000 person-years, respectively; hazard ratio [HR], 1.17; 95% CI, 1.14-1.21; P <.001). In addition, patients taking tamsulosin had a significantly higher dementia risk than those taking doxazosin (HR, 1.20; 95% CI, 1.12-1.28; P <.001), terazosin (HR, 1.11; 95% CI, 1.04-1.19; P =.002), alfuzosin (HR, 1.12; 95% CI, 1.03-1.22; P =.010), dutasteride (HR, 1.26; 95% CI, 1.19-1.34; P <.001), and finasteride (HR, 1.13; 95% CI, 1.07-1.19; P <.001).
According to the investigators, tamsulosin may simply unmask symptoms in patients with early-stage dementia. As such, because of the study’s nonrandomized and observational design, the investigators were unable to determine any causal relationships between tamsulosin and dementia risk.
The findings from this study may facilitate future changes in public health, “considering the number of elderly men who will require treatment for BPH during the next 2 decades.”
Duan Y, Grady JJ, Albertsen PC, Helen Wu Z. Tamsulosin and the risk of dementia in older men with benign prostatic hyperplasia [published online January 9, 2018]. Pharmacoepidemiol Drug Saf. doi:10.1002/pds.4361