title: The effects of dutasteride and finasteride on BPH-related hospitalization, surgery and prostate cancer diagnosis: a record-linkage analysis.
abstract: OBJECTIVE
  To investigate differences in the risk of benign prostatic hyperplasia (BPH)-related hospitalization, for surgical and non-surgical reasons, and of new prostate cancer (PCa) diagnosis between patients using finasteride or dutasteride.
  
  
  METHODS
  A retrospective cohort study was conducted using data from record linkage of administrative databases (pharmaceutical prescription data, hospital discharge records, Italian population registry). Men aged ≥ 40 years old who had received a prescription for at least 10 packs/year between January 1, 2004 and December 31, 2004 were included and followed for 5 years. The association of the outcomes was assessed using a multiple Cox proportional hazard model. Propensity score-matched analysis and a 5-1, greedy 1:1 matching algorithm were performed.
  
  
  RESULTS
  8,132 patients were identified. Overall incidence rates of BPH hospitalization and BPH-related surgery were 21.05 (95 % CI 19.52-22.71) and 20.97 (95 % CI 19.45-22.61) per 1,000 person-years, respectively. In the dutasteride group compared with finasteride group, the incidence rate of both events was statistically significant lower: 16.07 versus 21.76 for BPH hospitalization and 15.91 versus 21.69 for BPH-related surgery. The incidence rate of new PCa was also lower for the dutasteride group [8.34 (95 % CI 5.96-11.68) vs. 10.25 (95 % CI 9.15-11.49)]. Dutasteride was associated with a reduction in BPH-related hospitalizations (HR 0.75, 95 % CI 0.58-0.98 and 0.58-0.98 for surgical and non-surgical reasons). The matched analysis confirmed the risk reduction with dutasteride for BPH-related surgery.
  
  
  CONCLUSIONS
  These findings suggest that the clinical effects of dutasteride and finasteride might be different. Patients treated with dutasteride seem to be less likely to experience BPH-related hospitalization. Comparative studies are needed to confirm these results.
authors.affiliation: Department of Urology, S.Pio Da Pietrelcina Hospital, via Anelli, 82, 66054, Vasto, Italy. lucacindolo@virgilio.it
authors.forename: Luca
authors.initials: L
authors.lastname: Cindolo
authors.forename: Caterina
authors.initials: C
authors.lastname: Fanizza
authors.forename: Marilena
authors.initials: M
authors.lastname: Romero
authors.forename: Luisella
authors.initials: L
authors.lastname: Pirozzi
authors.forename: Riccardo
authors.initials: R
authors.lastname: Autorino
authors.forename: Francesco
authors.initials: F
authors.lastname: Berardinelli
authors.forename: Luigi
authors.initials: L
authors.lastname: Schips
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001378:Azasteroids / Q000627:therapeutic use*; D015331:Cohort Studies; D000068538:Dutasteride; D018120:Finasteride / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D059411:Lower Urinary Tract Symptoms / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008498:Medical Record Linkage; D008875:Middle Aged; D016016:Proportional Hazards Models; D011470:Prostatic Hyperplasia / Q000150:complications / Q000601:surgery*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D058891:5-alpha Reductase Inhibitors; D001378:Azasteroids; D018120:Finasteride; D000068538:Dutasteride