5-α Reductase Inhibitors Not Linked to Higher Fracture Risk

TUESDAY, Oct. 7 (HealthDay News) -- The use of 5-α reductase inhibitors for treatment of benign prostatic hyperplasia does not appear to raise the risk of hip fracture, and may even reduce the risk modestly, according to research published in the Oct. 8 issue of the Journal of the American Medical Association.

Steven J. Jacobsen, M.D., Ph.D., of Kaiser Permanente Southern California in Pasadena, and colleagues analyzed data from a case-control study with 7,076 men aged 45 and older with a new hip fracture over a 10-year period, and an equal number of men without hip fracture matched by age, race and ethnicity. All were enrolled in the Kaiser Permanente plan at the date of the fracture.

A small number of men -- 1.5 percent of cases and 2 percent of controls -- had a history of exposure to finasteride, a 5-α reductase inhibitor, creating a matched odds ratio of 0.77. The investigators also assessed a possible connection between fractures and α-blockers; men in the fracture group had a slightly higher -- but statistically significant -- prevalence of α-blocker use compared to controls (32 versus 30 percent).

"These data suggest that 5-α reductase inhibitors do not confer a negative risk for bone health and in fact may lower the risk of hip fracture. While presumably this lower risk is related to hormonal mechanisms, further understanding of the biological mechanisms underlying this phenomenon may lead to new insights that can be exploited for preventive measures. The increased risk of fracture associated with recent receipt of an α-blocker highlights the need for careful titration of these agents," the authors conclude.

Two of the study co-authors disclosed relationships with pharmaceutical companies.

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