World J Mens Health.
2020 Oct;38(4):535-544. 10.5534/wjmh.190046.
Risk of Depression after 5 Alpha Reductase Inhibitor Medication: Meta-Analysis
- Affiliations
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- 1Department of Urology, Stanford University Medical Center, Stanford, CA, USA.
- 2Department of Urology, Soonchunhyang University Seoul Hospital, Soon Chun Hyang University College of Medicine, Seoul, Korea.
- 3Department of Urological Biomedicine Research Institute, Soonchunhyang University Seoul Hospital, Soon Chun Hyang University College of Medicine, Seoul, Korea.
- 4Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
- 5Department of Urology, Sapienza University of Rome, Rome, Italy.
- 6Department of Urology, Aarhus University Hospital, Aarhus, Denmark.
- KMID: 2506418
- DOI: http://doi.org/10.5534/wjmh.190046
Abstract
- Purpose
Although five-alpha reductase inhibitor (5-ARI) is one of standard treatment for benign prostatic hyperplasia (BPH) or alopecia, potential complications after 5-ARI have been issues recently. This study aimed to investigate the risk of depression after taking 5-ARI and to quantify the risk using meta-analysis.
Materials and Methods
A total of 209,940 patients including 207,798 in 5-ARI treatment groups and 110,118 in control groups from five studies were included for final analysis. Inclusion criteria for finial analysis incudes clinical outcomes regarding depression risk in BPH or alopecia patients. Overall hazard ratio (HR) and odds ratio (OR) for depression were analyzed. Moderator analysis and sensitivity analysis were performed to determine whether HR or OR could be affected by any variables, including number of patients, age, study type, and control type.
Results
The pooled overall HRs for the 5-ARI medication was 1.23 (95% confidence interval [CI], 0.99–1.54) in a random effects model. The pooled overall ORs for the 5-ARI medication was 1.19 (95% CI, 0.95–1.49) in random effects model. The sub-group analysis showed that non-cohort studies had higher values of HR and OR than cohort studies. Moderator analysis using meta-regression showed that there were no variables that affect the significant difference in HR and OR outcomes. However, in sensitivity analysis, HR was significantly increased by age (p=0.040).
Conclusions
Overall risk of depression after 5-ARI was significantly not high, however its clinical importance needs validation by further studies. These quantitative results could provide useful information for both clinicians and patients.
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