Prostate Drug Combo May Lower Parkinson Risk

Men who use the glycolysis-enhancing drug combination terazosin/doxazosin/alfuzosin for the treatment of benign prostatic hyperplasia have a decreased risk of developing Parkinson disease (PD) compared with those who use tamsulosin, according to new findings published in JAMA Neurology.

Researchers arrived at this conclusion after performing a cohort study using active comparator control and propensity score-matched data obtained from several nationwide health registries in Denmark (n = 52,365 propensity score-matched pairs; mean age 67.9 years), including:

  • Danish National Prescription Registry
  • Danish National Patient Registry
  • Danish Civil Registration System

These data were from January 1996 to December 2017. Additional data from January 2001 to December 2017 were obtained from the US-based Truven Health Analytics MarketScan database (n = 94,883 propensity score-matched pairs; mean age 63.8 years).

The main outcome of the study was difference in likelihood of developing PD among patients who used terazosin/doxazosin/alfuzosin or tamsulosin at any point in their lives. In the study population, PD was identified by diagnoses or PD-specific medication use.

According to the results of the study, hazard ratios (HR) for developing PD were 0.88 among patients in the Danish cohort with terazosin/doxazosin/alfuzosin, and 0.63 among patients in the Truven cohort. The researchers identified a dose-response association between short-, medium-, and long-duration use of terazosin/doxazosin/alfuzosin and having a decreasing HR in both cohorts. HRs were as follows:

  • Short-duration use: 0.95 in the Danish cohort vs 0.70 in the Truven cohort
  • Medium-duration use: 0.88 in the Danish cohort vs 0.58 in the Truven cohort
  • Long-duration use: 0.79 in the Danish cohort vs 0.46 in the Truven cohort

“The combination of the strength of these results from 2 large databases in 2 different countries with different cultural and health care systems, the prior mechanistic studies, the results in animal models of PD, and the prior observational results from patients with PD provide compelling evidence that glycolysis-enhancing drugs might be neuroprotective and prevent or delay the development of PD,” the researchers wrote, noting that future investigation of this association is warranted.

—Christina Vogt

Simmering JE, Welsh MJ, Liu L, Narayanan NS, Pottegård A. Association of glycolysis-enhancing α-1 blockers with risk of developing Parkinson disease. JAMA Neurol. Published online February 1, 2021. doi:10.1001/jamaneurol.2020.5157