Hanan Goldberg1,2,3,4, Faizan K Mohsin5, Thenappan Chandrasekar6, Christopher J D Wallis1,7, Zachary Klaassen8, Ardalan E Ahmad1,2, Refik Saskin4, Miran Kenk1, Olli Saarela5, Girish S Kulkarni1,4, Shabbir M H Alibhai9, Neil Fleshner1. 1. Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, Toronto, ON, Canada. 2. Institute of Medical Science, University of Toronto, Toronto, ON, Canada. 3. Department of Urology, SUNY Upstate Medical University, Syracuse, NY, United States. 4. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada. 5. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. 6. Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia PA, United States. 7. Department of Urology, Vanderbilt University Medical Center, Nashville, TN, United States. 8. Division of Urology, Department of Surgery, Medical College of Georgia, Augusta University, Augusta, GA, United States; Georgia Cancer Center, GA, United States. 9. Department of Medicine, University Health Network and University of Toronto, Toronto, ON, Canada.
Abstract
INTRODUCTION: This was a secondary analysis aiming to assess whether hydrophilic or hydrophobic statins have a differential effect on urinary retention (UR) and lower urinary tract symptoms (LUTS) in men following a prostate biopsy (PBx), who were at risk for prostate cancer development. METHODS: This was a population-based cohort study with data incorporated from the Institute for Clinical and Evaluative Sciences database to identify all Ontarian men aged 66 and above with a history of a single negative PBx between 1994 and 2016, with no drug prescription history of any of several putative chemo-preventative medications (statins, proton pump inhibitors, five-alpha-reductase inhibitors, and alpha-blockers). Multivariable Cox regression models with time-dependent covariates were used to assess the association of hydrophilic and hydrophobic statins with UR and LUTS within 30 days of a PBx. All models were adjusted for other known putative chemopreventive medications, age, rurality, pharmacologically treated diabetes, comorbidity score, and study inclusion year. RESULTS: Overall, 21 512 men were included, with a median followup time of 9.4 years (interquartile range [IQR] 5.4-13.4 years). Hydrophobic and hydrophilic statins were initiated by 30.7% and 19.6% of men, respectively, after the first negative PBx. UR and LUTS were experienced by 2.2% and 10% of men, respectively. Cox models demonstrated hydrophilic statins were associated with a lower risk of UR (hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.38-0.83, p=0.0038) and LUTS (HR 0.86, 95% CI 0.76-0.98, p=0.022), while no such association was shown for hydrophobic statins. CONCLUSIONS: Initiation of hydrophilic statins in men older than 66 appears to be inversely associated with the risk of UR and LUTS within 30 days of a PBx.
INTRODUCTION: This was a secondary analysis aiming to assess whether hydrophilic or hydrophobic statins have a differential effect on urinary retention (UR) and lower urinary tract symptoms (LUTS) in men following a prostate biopsy (PBx), who were at risk for prostate cancer development. METHODS: This was a population-based cohort study with data incorporated from the Institute for Clinical and Evaluative Sciences database to identify all Ontarian men aged 66 and above with a history of a single negative PBx between 1994 and 2016, with no drug prescription history of any of several putative chemo-preventative medications (statins, proton pump inhibitors, five-alpha-reductase inhibitors, and alpha-blockers). Multivariable Cox regression models with time-dependent covariates were used to assess the association of hydrophilic and hydrophobic statins with UR and LUTS within 30 days of a PBx. All models were adjusted for other known putative chemopreventive medications, age, rurality, pharmacologically treated diabetes, comorbidity score, and study inclusion year. RESULTS: Overall, 21 512 men were included, with a median followup time of 9.4 years (interquartile range [IQR] 5.4-13.4 years). Hydrophobic and hydrophilic statins were initiated by 30.7% and 19.6% of men, respectively, after the first negative PBx. UR and LUTS were experienced by 2.2% and 10% of men, respectively. Cox models demonstrated hydrophilic statins were associated with a lower risk of UR (hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.38-0.83, p=0.0038) and LUTS (HR 0.86, 95% CI 0.76-0.98, p=0.022), while no such association was shown for hydrophobic statins. CONCLUSIONS: Initiation of hydrophilic statins in men older than 66 appears to be inversely associated with the risk of UR and LUTS within 30 days of a PBx.
Authors: Erik von Elm; Douglas G Altman; Matthias Egger; Stuart J Pocock; Peter C Gøtzsche; Jan P Vandenbroucke Journal: Ann Intern Med Date: 2007-10-16 Impact factor: 25.391
Authors: Susan A Hall; Gretchen R Chiu; Carol L Link; William D Steers; Varant Kupelian; John B McKinlay Journal: Ann Epidemiol Date: 2011-03 Impact factor: 3.797
Authors: Hanan Goldberg; Faizan K Mohsin; Refik Saskin; Girish S Kulkarni; Alejandro Berlin; Miran Kenk; Christopher J D Wallis; Zachary Klaassen; Thenappan Chandrasekar; Ardalan E Ahmad; Rashid K Sayyid; Olli Saarela; Linda Penn; Shabbir M H Alibhai; Neil Fleshner Journal: Eur Urol Focus Date: 2020-06-30