[The risk of fracture with taking alpha blockers for treating benign prostatic hyperplasia].
OBJECTIVE
We evaluated the risk of fracture associated with hypotension-related adverse drug reaction caused by taking alpha blockers to treat benign prostatic hyperplasia (BPH).


METHODS
We used the Health Insurance Review and Assessment Service database from January 1st 2005 to June 30th 2006 for this study. The male patients with BPH and who had a prescription for alpha blockers following any fractures were defined as the cases. We set the 20 day long hazard period prior to the index date and the four control periods whose lengths were same with hazard period. After 1:4 matching of the hazard and control periods, conditional logistic regression was used to calculate the odds ratios for the risk of fractures as related to the alpha blocker exposure.


RESULTS
Doxazosin and tamsulosin showed the increased risk of fractures, whereas terazosin did not. After stratification using the defined daily doses, a protective effect was shown for the patients who took terazosin at the doses lower than 0.4 DDD and the hazardous effect at the doses higher than or equal to 0.4 DDD. There was no significant difference for the risk of patients taking tamsulosin at the doses higher than 1.0 DDD but there was a statistically significant increase in the risk at the doses higher than or equal to 1.0 DDD.


CONCLUSIONS
Alpha blockers for BPH may increase the risk of fracture in elderly patients who have comorbidities and take the concomitant medications. Alpha blockers need to be prescribed with caution, although some have high prostate specificity.
Lee
Joongyub
J
Department of Preventive Medicine, Seoul National University College of Medicine, Korea.
Choi
Nam Kyoung
NK
Jung
Sun Young
SY
Kim
Ye Jee
YJ
Seong
Jong Mi
JM
Oh
Seung June
SJ
Park
Byung Joo
BJ
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D018592:Cross-Over Studies; D064420:Drug-Related Side Effects and Adverse Reactions / Q000150:complications; D050723:Fractures, Bone / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D011470:Prostatic Hyperplasia / Q000188:drug therapy*; D018570:Risk Assessment
D000317:Adrenergic alpha-Antagonists