Men who take phosphodiesterase type 5 (PDE5) inhibitors for erectile dysfunction (ED) are not at higher risk for biochemical recurrence of prostate cancer, according to new research published in European Urology.
ED is common after prostate cancer treatment, and PDE5 inhibitors are often the first-line treatment. However, a 2014 study by German scientists revealed an association between these drugs and biochemical recurrence in a group of men who had undergone radical prostatectomy.
Biochemical recurrence refers to elevated PSA levels after treatment, which suggest that prostate cancer could be coming back.
The current study used a nationwide population-based cohort to explore the connection further.
The team of European and American researchers analyzed data from the National Prostate Cancer Register of Sweden, linked to the Prescribed Drug Register. They compared five years of data for two groups of men who had been treated for localized prostate cancer, either by radical prostatectomy or radiation therapy.
Two hundred ninety-three men experienced biochemical recurrence. A comparison group of 5,767 men did not.
Fifty-one percent of the men in the biochemical recurrence group had used PDE5 inhibitors after treatment. In the comparison group, 58% had taken the ED drugs.
The researchers concluded that there was no association between PDE5 and increased risk for biochemical recurrence of prostate cancer. This remained the case after factors like PSA levels, stage of cancer, marital status, education, and income were considered.
“The main message for physicians is that they do not need to change their clinical practice,” lead author Stacy Loeb of New York University told Reuters Health. “PDE5 inhibitors remain first-line treatment for erectile dysfunction, and an increased risk of prostate cancer recurrence with these medications has not been confirmed.”
Loeb, Stacy, et al.
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(Abstract. Published online: December 30, 2015)
International Society for Sexual Medicine
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“Use of Phosphodiesterase Type 5 Inhibitors May Adversely Impact Biochemical Recurrence after Radical Prostatectomy”
(Full-text. Published online: September 5, 2014)
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(Reviewed: July 24, 2012)
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Reuters Health via Journal of Clinical Pathways
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(January 13, 2016)