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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2018

Open Access 01-12-2018 | Research article

A population-based study of the risk of osteoporosis and fracture with dutasteride and finasteride

Authors: Tony Antoniou, Erin M. Macdonald, Zhan Yao, Tara Gomes, Mina Tadrous, Joanne M.-W. Ho, Muhammad M. Mamdani, David N. Juurlink, for the Canadian Drug Safety and Effectiveness Research Network

Published in: BMC Musculoskeletal Disorders | Issue 1/2018

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Abstract

Background

Dutasteride is a potent inhibitor of 5-alpha reductase enzymes that reduces concentrations of dihydrotestosterone to a greater extent than finasteride. Whether this has adverse implications for bone health is unknown. We compared the risk of osteoporosis and fractures in older men treated with dutasteride or finasteride.

Methods

We conducted a population-based retrospective cohort study with high-dimensional propensity score matching of Ontario men aged 66 years or older who started treatment with dutasteride or finasteride between January 1, 2006 and December 31, 2012. The primary outcome was a diagnosis of osteoporosis within 2 years of treatment initiation. A secondary outcome was osteoporotic or fragility fractures.

Results

We studied 31,615 men treated with dutasteride and an equal number of men treated with finasteride. Dutasteride-treated patients had a lower incidence of osteoporosis than those receiving finasteride [2.2 versus 2.6 per 100 person years; hazard ratio (HR) 0.82; 95% confidence interval (CI) 0.72 to 0.93]. This effect was no longer statistically significant following adjustment for specialty of prescribing physician (HR 0.90; 95% CI 0.78 to 1.02)]. There was no differential risk of fractures with dutasteride (HR 1.04; 95% 0.86 to 1.25).

Conclusions

Despite differential effects on 5-alpha reductase, dutasteride is not associated with an increased risk of osteoporosis or fractures in older men relative to finasteride. These findings suggest that dutasteride does not adversely affect bone health.
Appendix
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Metadata
Title
A population-based study of the risk of osteoporosis and fracture with dutasteride and finasteride
Authors
Tony Antoniou
Erin M. Macdonald
Zhan Yao
Tara Gomes
Mina Tadrous
Joanne M.-W. Ho
Muhammad M. Mamdani
David N. Juurlink
for the Canadian Drug Safety and Effectiveness Research Network
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2018
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-018-2076-9

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