Prostate Drug Could Lead to Diabetes, Other Complications

Benign prostatic hyperplasia (BPH) commonly occurs in older men and is characterized by enlargement of the prostate. The condition can lead to a weakened urinary stream, infection, bladder stones, and reduced kidney stones; however, the condition is not thought to be a warning sign of prostate cancer.

The investigators of a new study published by Hormones Molecular Biology and Clinical Investigations discovered that a drug commonly prescribed to treat BPH may cause significant side effects. They found that treatment with dutsteride (Avodart) may place individuals at an increased risk of developing diabetes, high cholesterol, non-alcoholic fatty liver disease (NAFLD), and erectile dysfunction.

The authors advise physicians to be aware of these findings and discuss the potential metabolic and sexual side effects associated with dutsteride. In some cases, the risks may outweigh the benefits of the drug.

To help improve urinary retention and urinary tract symptoms, including frequent urination, many physicians prescribe alpha blockers, such as tamsulosin (Flomax), which relaxes the smooth muscle of the prostate to improve urinary flow, according to the study. Physicians also prescribe other drugs, such as finasteride (Proscar) or dutsteride, which reduce prostate volume to improve function.

"We believe our findings suggest that Avodart has a negative impact on men's overall health since it increases blood sugar and A1C and also increases blood lipids,” said corresponding author Abdulmaged M. Traish, MBA, PhD. “The increase in blood glucose and A1C may predispose men to diabetes and the increase in lipids may predispose them to NAFLD. Most importantly, this agent worsens sexual function and reduces quality of lie.”

Included in the study were patients with BPH who were either prescribed dutsteride or tamsulosin. Data about blood glucose, hemoglobin A1C, total cholesterol, LDL cholesterol, HDL cholesterol, and liver function enzymes were gathered over 36 to 42 months for each group of patients.

Patients additionally filled out questionnaires regarding their quality of life and assessed their sexual function according to the international index of erectile function.

The authors compared findings from both cohorts and discovered that patients treated with dutsteride were more likely to develop diabetes, high cholesterol, NAFLD, and worsening erectile dysfunction compared with the group treated with tamsulosin, according to the study.

The investigators believe that their findings, plus results from both clinical and animal studies, suggest that dutsteride may have significant side effects compared with other BPH treatments, according to the study.

"In order to reduce the negative impact on overall health and quality of life, physicians need to discuss with their patients the potential adverse side effects of taking Avodart," Dr Traish said.