MedicalResearch.com Interview with:
Juzar Jamnagerwalla, MD
Division of Urology, Department of Surgery
Cedars-Sinai Medical Center
Los Angeles, California
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In mouse models phosphodiesterase type-5 inhibitors (PDE-5i) have been shown to have anti-neoplastic activity, and given the routine use of PDE-5i for treatment of erectile dysfunction after prostatectomy several studies have examined the association between PDE-5i use and biochemical recurrence after treatment for prostate cancer with mixed findings. Only one previous study has explored the association between risk of prostate cancer, finding that men on PDE-5i had a lower chance of being diagnosed with prostate cancer. Given this, we tested the relationship between PDE-5i use and risk of prostate cancer in 6,501 men in the REDUCE study finding that PDE-5i use was not associated with prostate cancer diagnosis. On secondary analysis, among North American men who had a much higher baseline use of PDE-5i use, there was an inverse association between PDE-5i use and prostate cancer diagnosis, which approached, but did not reach statistical significance.
MedicalResearch.com: What should readers take away from your report?
Response: The data regarding the association between PDE-5i use and prostate cancer is mixed. Three recent studies have examined the association between PDE-5i use and biochemical recurrence in patients treated for prostate cancer, one finding that PDE-5i use was associated with a higher rate of biochemical recurrence and two others showing no association. One previous study showed that in infertile men with no personal history of prostate cancer, PDE-5i use was association with an overall decrease in the risk of new diagnosis of prostate cancer. A major limitation was that men taking PDE-5i in that study had a lower baseline PSA and not all men received biopsies.
In contrast, men in the REDUCE study all received study mandated biopsies at 2- and 4-years, thus cancer ascertainment was uniform in all men. In this setting, we found no association between PDE-5i use and risk of prostate cancer, although in North American men who at baseline had a much higher rate of PDE-5i use there was an inverse association between use of PDE-5i use and prostate cancer diagnosis that approached, but did not reach statistical significance.
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J Urol. 2016 Apr 5. pii: S0022-5347(16)30127-6. doi: 10.1016/j.juro.2016.03.172. [Epub ahead of print]
The Association between Phosphodiesterase Type 5 Inhibitors and Prostate Cancer: Results from the REDUCE Study.
Jamnagerwalla J1, Howard LE2, Vidal AC1, Moreira DM3, Castro-Santamaria R4, Andriole GL5, Freedland SJ6.
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