Risk of Age-Related Macular Degeneration in Men Receiving 5α-Reductase Inhibitors: A Population-Based Cohort Study

July 2024 in “ Age and Ageing ”

Yu‐Chen Su, Chin‐Yao Shen, Shih‐Chieh Shao, Chi‐Chun Lai, Sheng-Min Hsu, Chaw‐Ning Lee, Chan-Jung Liu, Jia‐Horung Hung, Edward Chia‐Cheng Lai

5α-reductase inhibitors 5ARIs tamsulosin dutasteride finasteride androgen inhibition Propecia Avodart

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Studysummary In this retrospective, population-based cohort study, researchers found no significant difference in age-related macular degeneration incidence between BPH patients using 5α-reductase inhibitors and those on tamsulosin, but observed a slight increased risk with dutasteride compared to finasteride.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

This study investigated the risk of age-related macular degeneration (AMD) in men with benign prostate hyperplasia (BPH) using 5α-reductase inhibitors (5ARIs) or tamsulosin. Data from 13,586 5ARIs users and 54,344 tamsulosin users were analyzed over an average follow-up of 3.7 years. The results showed no significant difference in AMD risk between 5ARIs and tamsulosin users overall. However, subgroup analysis revealed an increased risk of AMD in patients taking dutasteride (HR: 1.13) but not in those taking finasteride (HR: 0.99). This suggests that the potency of androgen inhibition may influence AMD incidence.

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research Macular Abnormalities Associated With 5α-Reductase Inhibitor

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This study suggests that the use of 5α-reductase inhibitors in men may be associated with macular abnormalities, characterized by cystoid changes and foveal cavitation, potentially progressing to more severe defects.

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This study concluded that men with benign prostatic hyperplasia receiving steroid 5α-reductase inhibitors, such as dutasteride or finasteride, have a higher risk of developing new onset type 2 diabetes compared to those taking tamsulosin.

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research The Direct Inhibitory Effect of Dutasteride or Finasteride on Androgen Receptor Activity Is Cell Line Specific

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This study found that dutasteride more effectively inhibited androgen receptor signaling and reduced cell growth compared to finasteride in prostate cancer cell models, with varying sensitivities across different cell lines.

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This review discusses the pharmacologic effects, safety, and efficacy of dutasteride and finasteride for BPH, finding similar clinical benefits but greater DHT reduction with dutasteride and reports no new trial results.