Association of Common Medication With Prostate-Specific Antigen Level in 45-Year-Old German Men: Results of the PROBASE Trial

    March 2019 in “ European Urology Supplements ”
    V.H. Meissner, Z. Ertilav, M. Kron, H. Schulwitz, P. Albers, C. Arsov, M. Kuczyk, F. Imkamp, M. Hohenfellner, B. Hadaschik, J.E. Gschwend, K. Herkommer
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    TLDR Some common medications like metformin, insulin, and ACE inhibitors can lower PSA levels, while statins don't, and low dose finasteride significantly reduces PSA.
    The study analyzed the effect of common medications on prostate-specific antigen (PSA) levels in 13,021 45-year-old German men as part of the PROBASE trial. The results indicated that the use of metabolic agents like metformin and insulin, as well as cardiovascular agents such as angiotensin-converting enzyme (ACE) inhibitors, was associated with lower PSA levels by 20%, 14%, and 7% respectively, all with statistical significance (p<0.01). Central nervous system agents did not affect PSA levels. Additionally, low dose finasteride therapy (1 mg), typically used for male androgenetic alopecia, resulted in a median decrease in PSA level of 31% (p<0.001). The study concluded that metformin, insulin, and ACE inhibitors are associated with a reduction in PSA levels, while statins did not show a decrease in PSA levels, contrary to previous studies. The significant decrease in PSA levels with 1 mg finasteride suggests that the same recommendations for interpreting PSA tests should be applied as for the higher 5 mg/day dose.
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