Tadalafil use is associated with a lower incidence of Type 2 diabetes in men with benign prostatic hyperplasia: A population-based cohort study

IF 9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Journal of Internal Medicine Pub Date : 2024-09-17 DOI:10.1111/joim.20012

Atsushi Takayama, Satomi Yoshida, Koji Kawakami

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引用次数: 0

Abstract

Background

Tadalafil, commonly prescribed for benign prostatic hyperplasia (BPH), may benefit patients with Type 2 diabetes mellitus (T2DM) for glycemic markers and complications. However, the association between the long-term use of tadalafil and the incidence of T2DM has not been investigated.

Methods

We emulated a target trial of tadalafil use (5 mg/day) and the risk of T2DM using a population-based claims database in Japan. Patients who initiated tadalafil or alpha-blockers for BPH and had no history of diabetes diagnosis, no dispensing of glucose-lowering drugs, and no history of hemoglobin A1c levels of ≥6.5% (47–48 mmol/mol) were included. The primary outcome was the incidence of T2DM. Pooled logistic regression was used to estimate adjusted risk ratios (RRs) and 5-year cumulative incidence differences (CIDs).

Results

A total of 5180 participants initiated tadalafil treatment and were compared with 20,049 patients who initiated alpha-blockers. The median follow-up time for each arm was 27.2 months (interquartile range [IQR], 12.0–47.9) in tadalafil users and 31.3 months (IQR, 13.7–57.2) in alpha-blocker users. The incidence rates of T2DM in tadalafil and alpha-blocker users were 5.4 (95% confidence interval [CI], 4.0–7.2) and 8.8 (95% CI, 7.8–9.8) per 1000-person years, respectively. Initiation of tadalafil was associated with a reduced risk of T2DM (RR, 0.47; 95% CI, 0.39–0.62; 5-year CID, −0.031; 95% CI, −0.040 to −0.019).

Conclusion

The incidence of T2DM was lower in men with BPH treated with tadalafil than in those treated with alpha-blockers. Thus, tadalafil may be more beneficial than alpha-blockers in preventing T2DM.

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使用他达拉非与良性前列腺增生男性 2 型糖尿病发病率降低有关：一项基于人群的队列研究

背景他达拉非是治疗良性前列腺增生症（BPH）的常用处方药，可能对2型糖尿病（T2DM）患者的血糖指标和并发症有益。然而，长期服用他达拉非与 T2DM 发病率之间的关系尚未得到研究。方法我们利用日本的人口索赔数据库，模拟了他达拉非服用量（5 毫克/天）与 T2DM 风险的目标试验。我们纳入了开始使用他达拉非或α-受体阻滞剂治疗良性前列腺增生症的患者，这些患者没有糖尿病诊断史，没有服用过降糖药物，也没有血红蛋白 A1c 水平≥6.5%（47-48 mmol/mol）的病史。主要结果是 T2DM 的发病率。结果共有5180名患者接受了他达拉非治疗，并与20049名接受α-受体阻滞剂治疗的患者进行了比较。他达拉非使用者的中位随访时间为27.2个月（四分位距[IQR]为12.0-47.9），α-受体阻滞剂使用者的中位随访时间为31.3个月（四分位距[IQR]为13.7-57.2）。他达拉非和阿尔法受体阻滞剂使用者的 T2DM 发病率分别为每千人年 5.4 例（95% 置信区间 [CI]，4.0-7.2）和 8.8 例（95% 置信区间 [CI]，7.8-9.8）。服用他达拉非与T2DM风险降低有关（RR，0.47；95% CI，0.39-0.62；5年CID，-0.031；95% CI，-0.040至-0.019）。因此，在预防T2DM方面，他达拉非可能比α-受体阻滞剂更有益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Internal Medicine 医学-医学：内科

CiteScore

22.00

自引率

0.90%

发文量

176

审稿时长

4-8 weeks

期刊介绍： JIM – The Journal of Internal Medicine, in continuous publication since 1863, is an international, peer-reviewed scientific journal. It publishes original work in clinical science, spanning from bench to bedside, encompassing a wide range of internal medicine and its subspecialties. JIM showcases original articles, reviews, brief reports, and research letters in the field of internal medicine.