Impact of commonly used medications on the detection of clinically significant prostate cancer in the targeted biopsy era.

Abstract

Objectives: To compare prostate cancer rates in magnetic resonance imaging (MRI)-detected lesions for patients who are chronically taking beta-blockers, nonsteroidal anti-inflammatory drugs (NSAIDs), or immunosuppressors.

Methods: This cohort consisted of 897 Prostate Imaging Reporting & Data System (PI-RADS)v2 3-5 lesions from 590 MRI-targeted fusion prostate biopsies (UroNav). Baseline characteristics and clinicopathological data were collected. A matching cohort was analyzed, and multivariate analysis was completed for each medication group. Matching analysis accounted for age, prostate-specific antigen (PSA), and PI-RADS score. Multivariate analysis additionally considered lesion size.

Results: Of the 897 lesions, 261/897 (29%) of lesions were identified as PI-RADS 3, 373/897 (42%) were PI-RADS 4, and 263/897 (29%) were PI-RADS 5. In the patient cohort, 16% were taking a beta-blocker, 3.9% were taking an NSAID, and 5.4% were taking an immunosuppressant. An equal number of lesions in controls were matched to 148 lesions in males taking beta-blockers, 37 lesions in males taking NSAIDs, and 46 lesions in males taking immunosuppressants. Matching was based on age, PSA, and PI-RADS score. In the matched cohort, neither beta-blockers, NSAIDs, nor immunosuppressants altered clinically significant prostate cancer (csPCa) identification on MRI (OR 1.11, CI 95% 0.6, 1.9; OR 0.70, CI 95% 0.32, 1.66; OR 1.73, CI 95% 0.59, 5.35, respectively).

Conclusion: This pilot study shows no difference in csPCa detection rates in patients using anti-inflammatories or drugs that alter prostate blood flow.