Differential Association Between Cumulative Dose of 5α-Reductase Inhibitors and Mortality

The study investigated the relationship between cumulative doses of 5α-reductase inhibitors (5-ARIs) and mortality in patients with benign prostatic hyperplasia (BPH) or androgenic alopecia (AGA). It included 3,084 cases and 14,630 controls. Results showed that lower cumulative doses (<365 cDDDs and 365–730 cDDDs) were associated with higher mortality rates, while higher doses (>5840 cDDDs) significantly reduced mortality risk. Additionally, lower cumulative doses were linked to higher suicide rates, whereas higher doses were associated with lower cardiovascular mortality rates. The study underscores the need for careful monitoring of patients on 5-ARIs due to the complex relationship between dosage and mortality, particularly the increased risk of suicide at lower doses.