台灣使用5-alpha-reductase inhibitor 治療的臨床結果
謝登富、劉昕和、林殿璜、李祥生、蔡宗訓、陳至正
台中慈濟醫院泌尿科；花蓮慈濟大學醫院
Clinical result of 5-alpha-reductase inhibitor therapy in Taiwan
Teng-Fu Hsieh, Hsin-Ho Liu, Tien-Huang Lin, Shang-Sen Lee, Tsung-Hsun Tsai, Chi-Cheng Chen
Department of Urology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan；School of Medicine, Tzu Chi University, Hualian, Taiwan
Purpose: The aim of this study is to investigate the clinical outcome of 5-alpha-reductase inhibitor (5ARI) therapy using the National Health Insurance Research Database (NHIRD) in Taiwan.
Materials and Methods: In total, 1586 adult patients with 5ARI for more than 180cDDD (long-term treatment group) and 1923 adult patients with 5ARI between 28 cDDD and 180cDDD (short-term treatment group) were recruited as the study group cohort, along with 624 subjects who have 5ARI between 7 cDDD and 27cDDD as a control group between January 1, 2002 and December 31, 2011. Each patient was monitored to identify those who subsequently developed urine retention or prostate surgery. A Cox proportional hazards model was used to compare the risk of urine retention or prostate surgery between the study and comparison cohorts after adjusting for possible confounding risk factors.
Results: Prostate surgery and urine retention are detected in 5.6% of control group, 7.6% of short-term treatment group and 5.5% of long-term treatment group during 10-year follow up. Compared with the control group, there was no difference in the risk of TURP and AUR in the short-term and long-term treatment groups (HR=1.41, 95% CI 0.76 to 2.62 and HR=0.81, 95% CI 0.42 to 1.56, respectively).
Conclusion: 5ARI therapy did not change the risk of TURP and AUR events under current Taiwan’s National Health Insurance regulates. Further mechanistic research is warranted to validate the results.