Prostate cancer specific mortality after 5α-reductase inhibitors medication in benign prostatic hyperplasia patients: systematic review and meta-analysis

Abstract

Background

Our study was conducted to investigate the effect of 5-ARI on the death rate from prostate cancer by means of an updated meta-analysis using related data.

Methods

We did comprehensive literature searches using the PubMed, Embase, and Cochrane databases through July 2019. We evaluated the risk of bias in such studies using the ROBINS-I tool and analyzed deaths from cancer and deaths from all causes using HR.

Results

The meta-analysis included 11 studies. The pooled overall HRs for cancer-specific deaths between 5-ARI treatment versus non-exposed groups were 0.937 (95% CI: 0.730, 1.201). In the subgroup moderator analysis, the number of patients and additional medication variables were significantly associated with deaths from all causes (p = 0.022 and p = 0.005, respectively). For detecting the publication bias or small-study effect in the included studies, we performed Begg and Mazumdar’s correlation test (0.851 and 0.573) and Egger’s regression coefficient test (0.035 and 0.245) and ​suggested that there was no evidence of publication bias or small-study effect in this meta-analysis.

Conclusions

Our study indicated that exposure to 5-ARI had no close association between the overall death rate or cancer-specific deaths. To confirm these results, well-designed prospective studies with large samples are required.

Keywords:

• Prostate cancer
• 5?-reductase inhibitors
• BPH
• meta-analysis
• cancer specific mortality

Author contributions

Study design and conceptualization: JHK; Data extraction and synthesis: HYL; Data-analysis and interpretation: SRS, JHK; Draft the manuscript: JJP; Draft revision: JHK

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work wassupported by Soonchunhyang University Research Fund.