Matthew B Harrell1, Kaylee Ho2, Alexis E Te3,4, Steven A Kaplan5, Bilal Chughtai6,7,8. 1. Weill Cornell Medical College, New York, NY, USA. 2. Clinical and Translational Science Center at Weill Cornell Medical College, New York, NY, USA. 3. Department of Urology, New York Presbyterian, Weill Cornell Medical College, New York, NY, USA. 4. Department of Urology, Weill Cornell Medical College, New York, USA. 5. Mount Sinai Department of Urology, Icahn School of Medicine, New York, NY, USA. 6. Department of Urology, New York Presbyterian, Weill Cornell Medical College, New York, NY, USA. bic9008@med.cornell.edu. 7. Department of Obstetrics and Gynecology, Weill Cornell Medical College, 425 East 61st Street, 12th Floor, New York, NY, 10065, USA. bic9008@med.cornell.edu. 8. Department of Urology, Weill Cornell Medical College, New York, USA. bic9008@med.cornell.edu.
Abstract
OBJECTIVE: To investigate the sexual, physical, and mental adverse effects associated with exposure to 5-alpha reductase inhibitors (5ARIs). METHODS: FAERS data containing finasteride and dutasteride reports were analyzed from January 2000 to April 2019. Reports identified one or more adverse effects, along with all concurrent medications. Cases of monotherapy of finasteride or dutasteride were identified. We conducted a chi-square test of independence to assess the relationship between the three drug groups and adverse event (AE) occurrence across 19 sexual, physical, and mental AE categories. The frequency procedure in SAS was utilized to summarize rates of AEs between various dosages of each drug. RESULTS: A total of 16,014 case reports were obtained. After excluding females, 7436 case reports of 5ARI monotherapy were identified: 2628 of dutasteride 0.5 mg, 3266 of finasteride 1 mg, and 744 of finasteride 5 mg. Differences in rates of AEs occurrence were statistically significant across all 19 variables (p < 0.001) with a significantly higher proportion of AEs attributed to finasteride 1 mg, with gynecomastia being the only exception. Case report submissions rose dramatically following FDA-mandated finasteride label change. CONCLUSIONS: Analysis of FAERS data suggests AEs of 5ARIs are dose-independent with greater likelihood of occurrence in younger patients, particularly in sexual and mental domains. The causality and the rate of AEs are not certain based on the FAERS data and future prospective studies are necessary to determine the true rates.
OBJECTIVE: To investigate the sexual, physical, and mental adverse effects associated with exposure to 5-alpha reductase inhibitors (5ARIs). METHODS: FAERS data containing finasteride and dutasteride reports were analyzed from January 2000 to April 2019. Reports identified one or more adverse effects, along with all concurrent medications. Cases of monotherapy of finasteride or dutasteride were identified. We conducted a chi-square test of independence to assess the relationship between the three drug groups and adverse event (AE) occurrence across 19 sexual, physical, and mental AE categories. The frequency procedure in SAS was utilized to summarize rates of AEs between various dosages of each drug. RESULTS: A total of 16,014 case reports were obtained. After excluding females, 7436 case reports of 5ARI monotherapy were identified: 2628 of dutasteride 0.5 mg, 3266 of finasteride 1 mg, and 744 of finasteride 5 mg. Differences in rates of AEs occurrence were statistically significant across all 19 variables (p < 0.001) with a significantly higher proportion of AEs attributed to finasteride 1 mg, with gynecomastia being the only exception. Case report submissions rose dramatically following FDA-mandated finasteride label change. CONCLUSIONS: Analysis of FAERS data suggests AEs of 5ARIs are dose-independent with greater likelihood of occurrence in younger patients, particularly in sexual and mental domains. The causality and the rate of AEs are not certain based on the FAERS data and future prospective studies are necessary to determine the true rates.
Authors: R S Rittmaster; A Lemay; H Zwicker; T P Capizzi; S Winch; E Moore; G J Gormley Journal: J Clin Endocrinol Metab Date: 1992-08 Impact factor: 5.958
Authors: Antonio Alcaraz; David Castro-Díaz; Mauro Gacci; Andrea Salonia; Vincenzo Ficarra; Joaquín Carballido-Rodríguez; Alfredo Rodríguez-Antolín; José Medina-Polo; Jesús M Fernández-Gómez; José M Cózar-Olmo; Santiago Búcar-Terrades; Noemí Pérez-León; Francisco J Brenes-Bermúdez; José M Molero-García; Antonio Fernández-Pro-Ledesma; Michael Herdman; Javier C Angulo; José Manasanch Journal: J Clin Med Date: 2022-06-22 Impact factor: 4.964