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

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.