Statin use may be associated with a modest decrease in prostate volume (PV) growth, according to investigators.
The finding is from an analysis of data from 4106 men who participated in the REDUCE trial, a 4-year randomized, double-blind, controlled trial compared dutasteride with placebo for the chemoprevention of prostate cancer. Of these men, 692 (17%) were statin users at baseline.
In the dutasteride arm, the estimated mean PV decreased from 45.7 cc at baseline to 39.6 cc at 2 years (a 13% reduction) and remained stable at 4 years (39.8 cc), a team led by Stephen J. Freedland, MD, of Cedars-Sinai Medical Center in Los Angeles, reported in BJU International.
The estimated mean PV increased over time in the placebo arm from 45.6 cc at baseline to 51.9 cc at 2 years and 58 cc at 4 years, corresponding to a mean increase in PV of 12.4 cc, or 27%, over the 4-year trial period.
In the dutasteride arm, statin users had a slightly but significantly smaller mean estimated PV compared with nonusers at 2 years (38.1 vs 39.9 cc) and 4 years (38.5 vs 40.1 cc). In the placebo arm, the mean estimated PV was slightly lower among statin users compared with nonusers at the 2- and 4-year time points (50.4 vs 52.1 cc and 56.6 vs 58.3 cc, respectively), but the differences were not significant. Statin use was not associated with PV at baseline.
Dr Freedland and his collaborators stated that their findings, if confirmed, support a role for statins in modestly attenuation PV growth, “with a magnitude of effect in line with previously-reported PSA-lower effects of statins.”
“Given that prostate enlargement and BPH are prevalent conditions in Western society conferring a reduced quality of life, it is possible that even modest attenuation of prostate enlargement could have a clinical and public health benefit,” the authors concluded.
In a discussion of study limitations, Dr Freedland’s team noted that they lacked data regarding statin type and dose, and duration of use, so they did not know how long men were using statins prior to trial enrollment. In addition, the investigators noted that they lacked data on adherence, so they did not know if men continued their statin use during follow-up.
Allott EH, Csizmadi I, Howard LE, et al. Statin use and longitudinal changes in prostate volume: results from the REDUCE trial [published online September 3, 2019]. BJU Int.