The following is a summary of “Association of Terazosin, Doxazosin, or Alfuzosin Use and Risk of Dementia With Lewy Bodies in Men,” published in the June 2024 issue of Neurology by Hart, et al.
Studies investigating Terazosin, Doxazosin, and Alfuzosin (Tz/Dz/Az) revealed increased brain adenosine triphosphate (ATP) levels, leading to the hypothesis of neuroprotective potential in Parkinson’s disease.
Researchers conducted a retrospective study investigating the potential neuroprotective effects of Tz/Dz/Az in dementia with Lewy bodies (DLB).
They employed a novel active comparator design within the Merative Marketscan database, identifying men without prior DLB history who initiated treatment with Tz/Dz/Az or two comparators. The comparators included tamsulosin, an α-1 adrenergic receptor antagonist, or 5α-reductase inhibitor (5ARI), commonly used for benign prostatic hyperplasia without ATP elevation. Cohorts were matched based on propensity scores and follow-up duration. Using Cox proportional hazards regression, the matched cohorts were tracked forward to assess DLB hazard development.
The results showed men newly using Tz/Dz/Az had a reduced risk of DLB compared to those taking tamsulosin (n = 242,716, 728,256 person-years, HR 0.60, 95% CI 0.50–0.71) or 5ARI (n = 130,872, 399,316 person-years, HR 0.73, 95% CI 0.57–0.93). The DLB risk with tamsulosin was similar to that with 5ARI (n = 159,596, 482,280 person-years, HR 1.17, 95% CI 0.96–1.42). The findings remained consistent across multiple sensitivity analyses.
Investigators observed an association between men taking Tz/Dz/Az and a lower risk of DLB than those on other medications, suggesting broader neuroprotective effects of glycolysis-enhancing drugs in DLB. However, RCTs were needed to confirm causation.
Source: neurology.org/doi/10.1212/WNL.0000000000209570
The post Predicting Risk in Men with DLB via Influence of Terazosin, Doxazosin, or Alfuzosin first appeared on Physician's Weekly.