Spironolactone use tied to lower risk for prostate cancer

  • Beckmann K & al.
  • Prostate Cancer Prostatic Dis
  • 2 Mar 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Spironolactone use was associated with a lower risk for prostate cancer (PCa).
  • Risk reduction was greater in current users than past users and the risk decreased with increasing dose.

Why this matters

  • Findings warrant future studies to determine the chemotherapeutic effects of spironolactone.

Study design

  • A population-wide, case-control study included 31,591 men with PCa (cases) and 156,802 age- and county-matched men without PCa (controls).
  • Funding: None disclosed.

Key results

  • In multivariable analyses, spironolactone vs control group had a lower risk for PCa (OR, 0.83; 95% CI, 0.76-0.89).
  • Risk reduction was higher in current users (OR, 0.77; 95% CI, 0.69-0.86) than past users (OR, 0.88; 95% CI, 0.79-0.97) and the risk decreased with increasing dose (Ptrend<.001>
  • Spironolactone use was linked with lower risk for PCa across all grade, prostate-specific antigen (PSA) categories and risk groups:
    • Grade:
      • 1 (OR, 0.79; 95% CI, 0.68-0.92);
      • 2 (OR, 0.86; 95% CI, 0.73-1.00);
      • 3 (OR, 0.68; 95% CI, 0.55-0.84); and
      • 4 (OR, 0.85; 95% CI, 0.68-1.06).
    • PSA categories (in ng/ml):
      • 3 to
      • 10 to
      • 20 to
      • 50+ (OR, 0.88; 95% CI, 0.73-1.05).
    • Risk groups:
      • low (OR, 0.85; 95% CI, 0.70-1.02);
      • intermediate (OR, 0.82; 95% CI, 0.71-0.95);
      • high (OR, 0.78; 95% CI, 0.67-0.91); and
      • advanced/metastatic (OR, 0.92; 95% CI, 0.79-1.07).

Limitation

  • Lack of data on potential confounders such as body weight and other health behaviours.