Statin use and longitudinal changes in prostate volume; results from the REduction by DUtasteride of prostate Cancer Events (REDUCE) trial

Emma H. Allott, Ilona Csizmadi, Lauren E. Howard, Roberto L. Muller, Daniel M. Moreira, Gerald L. Andriole, Claus G. Roehrborn, Stephen J. Freedland

Research output: Contribution to journalArticle

Abstract

Objective: To test the association between statin use and prostate volume (PV) change over time using data from the REduction by DUtasteride of prostate Cancer Events (REDUCE) trial, a 4-year randomised controlled trial testing dutasteride for prostate cancer chemoprevention. Subjects/Patients and Methods: We identified men with a baseline negative prostate biopsy from REDUCE who did not undergo prostate surgery or develop prostate cancer over the trial period. Men reported statin use at baseline. PV was determined from transrectal ultrasonography performed to guide prostate biopsy at baseline, and 2- and 4-years after randomisation. Multivariable generalised estimating equations tested differences in PV change over time by statin use, overall and stratified by treatment arm. We tested for interactions between statins and time in association with PV using the Wald test. Results: Of 4106 men, 17% used statins at baseline. Baseline PV did not differ by statin use. Relative to non-users, statin users had decreasing PVs over the trial period (P = 0.027). Similar patterns were seen in the dutasteride and placebo arms, although neither reached statistical significance. The mean estimated PV was modestly but significantly lower in statin users relative to non-users in the dutasteride arm at 2-years (4.5%, P = 0.032) and 4-years (4.0%, P = 0.033), with similar (3–3.3%) but non-significant effects in the placebo arm. Conclusion: If confirmed, our present findings support a role for statins in modestly attenuating PV growth, with a magnitude of effect in line with previously reported prostate-specific antigen-lowering effects of statins (~4%). Future studies are needed to assess whether this putative role for statins in PV growth could impact lower urinary tract symptom development or progression.

Original languageEnglish (US)
JournalBJU international
DOIs
StateAccepted/In press - Jan 1 2019

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Prostate
Prostatic Neoplasms
Dutasteride
Biopsy
Lower Urinary Tract Symptoms
Placebo Effect
Chemoprevention
Prostate-Specific Antigen
Growth
Random Allocation
Ultrasonography
Randomized Controlled Trials
Placebos

Keywords

  • #PCSM
  • #ProstateCancer
  • 5α-reductase inhibitors/therapeutic use
  • Body mass index
  • Middle aged
  • Obesity
  • Prostate

ASJC Scopus subject areas

  • Urology

Cite this

Allott, E. H., Csizmadi, I., Howard, L. E., Muller, R. L., Moreira, D. M., Andriole, G. L., ... Freedland, S. J. (Accepted/In press). Statin use and longitudinal changes in prostate volume; results from the REduction by DUtasteride of prostate Cancer Events (REDUCE) trial. BJU international. https://doi.org/10.1111/bju.14905

Statin use and longitudinal changes in prostate volume; results from the REduction by DUtasteride of prostate Cancer Events (REDUCE) trial. / Allott, Emma H.; Csizmadi, Ilona; Howard, Lauren E.; Muller, Roberto L.; Moreira, Daniel M.; Andriole, Gerald L.; Roehrborn, Claus G.; Freedland, Stephen J.

In: BJU international, 01.01.2019.

Research output: Contribution to journalArticle

Allott, Emma H. ; Csizmadi, Ilona ; Howard, Lauren E. ; Muller, Roberto L. ; Moreira, Daniel M. ; Andriole, Gerald L. ; Roehrborn, Claus G. ; Freedland, Stephen J. / Statin use and longitudinal changes in prostate volume; results from the REduction by DUtasteride of prostate Cancer Events (REDUCE) trial. In: BJU international. 2019.
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title = "Statin use and longitudinal changes in prostate volume; results from the REduction by DUtasteride of prostate Cancer Events (REDUCE) trial",
abstract = "Objective: To test the association between statin use and prostate volume (PV) change over time using data from the REduction by DUtasteride of prostate Cancer Events (REDUCE) trial, a 4-year randomised controlled trial testing dutasteride for prostate cancer chemoprevention. Subjects/Patients and Methods: We identified men with a baseline negative prostate biopsy from REDUCE who did not undergo prostate surgery or develop prostate cancer over the trial period. Men reported statin use at baseline. PV was determined from transrectal ultrasonography performed to guide prostate biopsy at baseline, and 2- and 4-years after randomisation. Multivariable generalised estimating equations tested differences in PV change over time by statin use, overall and stratified by treatment arm. We tested for interactions between statins and time in association with PV using the Wald test. Results: Of 4106 men, 17{\%} used statins at baseline. Baseline PV did not differ by statin use. Relative to non-users, statin users had decreasing PVs over the trial period (P = 0.027). Similar patterns were seen in the dutasteride and placebo arms, although neither reached statistical significance. The mean estimated PV was modestly but significantly lower in statin users relative to non-users in the dutasteride arm at 2-years (4.5{\%}, P = 0.032) and 4-years (4.0{\%}, P = 0.033), with similar (3–3.3{\%}) but non-significant effects in the placebo arm. Conclusion: If confirmed, our present findings support a role for statins in modestly attenuating PV growth, with a magnitude of effect in line with previously reported prostate-specific antigen-lowering effects of statins (~4{\%}). Future studies are needed to assess whether this putative role for statins in PV growth could impact lower urinary tract symptom development or progression.",
keywords = "#PCSM, #ProstateCancer, 5α-reductase inhibitors/therapeutic use, Body mass index, Middle aged, Obesity, Prostate",
author = "Allott, {Emma H.} and Ilona Csizmadi and Howard, {Lauren E.} and Muller, {Roberto L.} and Moreira, {Daniel M.} and Andriole, {Gerald L.} and Roehrborn, {Claus G.} and Freedland, {Stephen J.}",
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T1 - Statin use and longitudinal changes in prostate volume; results from the REduction by DUtasteride of prostate Cancer Events (REDUCE) trial

AU - Allott, Emma H.

AU - Csizmadi, Ilona

AU - Howard, Lauren E.

AU - Muller, Roberto L.

AU - Moreira, Daniel M.

AU - Andriole, Gerald L.

AU - Roehrborn, Claus G.

AU - Freedland, Stephen J.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: To test the association between statin use and prostate volume (PV) change over time using data from the REduction by DUtasteride of prostate Cancer Events (REDUCE) trial, a 4-year randomised controlled trial testing dutasteride for prostate cancer chemoprevention. Subjects/Patients and Methods: We identified men with a baseline negative prostate biopsy from REDUCE who did not undergo prostate surgery or develop prostate cancer over the trial period. Men reported statin use at baseline. PV was determined from transrectal ultrasonography performed to guide prostate biopsy at baseline, and 2- and 4-years after randomisation. Multivariable generalised estimating equations tested differences in PV change over time by statin use, overall and stratified by treatment arm. We tested for interactions between statins and time in association with PV using the Wald test. Results: Of 4106 men, 17% used statins at baseline. Baseline PV did not differ by statin use. Relative to non-users, statin users had decreasing PVs over the trial period (P = 0.027). Similar patterns were seen in the dutasteride and placebo arms, although neither reached statistical significance. The mean estimated PV was modestly but significantly lower in statin users relative to non-users in the dutasteride arm at 2-years (4.5%, P = 0.032) and 4-years (4.0%, P = 0.033), with similar (3–3.3%) but non-significant effects in the placebo arm. Conclusion: If confirmed, our present findings support a role for statins in modestly attenuating PV growth, with a magnitude of effect in line with previously reported prostate-specific antigen-lowering effects of statins (~4%). Future studies are needed to assess whether this putative role for statins in PV growth could impact lower urinary tract symptom development or progression.

AB - Objective: To test the association between statin use and prostate volume (PV) change over time using data from the REduction by DUtasteride of prostate Cancer Events (REDUCE) trial, a 4-year randomised controlled trial testing dutasteride for prostate cancer chemoprevention. Subjects/Patients and Methods: We identified men with a baseline negative prostate biopsy from REDUCE who did not undergo prostate surgery or develop prostate cancer over the trial period. Men reported statin use at baseline. PV was determined from transrectal ultrasonography performed to guide prostate biopsy at baseline, and 2- and 4-years after randomisation. Multivariable generalised estimating equations tested differences in PV change over time by statin use, overall and stratified by treatment arm. We tested for interactions between statins and time in association with PV using the Wald test. Results: Of 4106 men, 17% used statins at baseline. Baseline PV did not differ by statin use. Relative to non-users, statin users had decreasing PVs over the trial period (P = 0.027). Similar patterns were seen in the dutasteride and placebo arms, although neither reached statistical significance. The mean estimated PV was modestly but significantly lower in statin users relative to non-users in the dutasteride arm at 2-years (4.5%, P = 0.032) and 4-years (4.0%, P = 0.033), with similar (3–3.3%) but non-significant effects in the placebo arm. Conclusion: If confirmed, our present findings support a role for statins in modestly attenuating PV growth, with a magnitude of effect in line with previously reported prostate-specific antigen-lowering effects of statins (~4%). Future studies are needed to assess whether this putative role for statins in PV growth could impact lower urinary tract symptom development or progression.

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KW - #ProstateCancer

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KW - Body mass index

KW - Middle aged

KW - Obesity

KW - Prostate

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