Link To Neurology Abstract “Association of Terazosin, Doxazosin, or Alfuzosin Use and Risk of Dementia With Lewy Bodies in Men” With A Link To An Additional Resource

In addition to today’s resource, please see and review Surprising Breakthrough: Prostate Drugs Offer New Hope in Dementia Prevention. TOPICS:DementiaNeurosciencePharmaceuticalsPopularUniversity Of Iowa

Prostate drugs such as terazosin may reduce the risk of dementia with Lewy bodies by 40%, according to a study, suggesting their potential beyond prostate health to possibly preventing neurodegenerative diseases.

Research suggests that drugs for enlarged prostate, like terazosin and doxazosin, may also protect against dementia with Lewy bodies by enhancing brain cell energy production.

A study of over 643,000 men showed that those on these drugs had a 40% lower risk of developing DLB, pointing to potential new uses for these medications in neurodegenerative disease prevention.

Today, I link to the Neurology abstract Association of Terazosin, Doxazosin, or Alfuzosin Use and Risk of Dementia With Lewy Bodies in Men. July 23, 2024 issue
103 (2) Alexander Hart, MD, MPH, Georgina Aldridge, MD, PhD, Qiang Zhang, MD, Nandakumar S. Narayanan, MD, PhD, and Jacob E. Simmering, PhD

All that follows is from the above resource.

Association of Terazosin, Doxazosin, or Alfuzosin Use and Risk of Dementia With Lewy Bodies in Men



Background and objectives: Terazosin, doxazosin, and alfuzosin (Tz/Dz/Az) are α-1 adrenergic receptor antagonists that also bind to and activate a key adenosine triphosphate (ATP)-producing enzyme in glycolysis. It is hypothesized that the increase in energy availability in the brain may slow or prevent neurodegeneration, potentially by reducing the accumulation of alpha-synuclein. Recent work has suggested a potentially neuroprotective effect of the use of Tz/Dz/Az in Parkinson disease in both animal and human studies. We investigated the neuroprotective effects of Tz/Dz/Az in a closely related disease, dementia with Lewy bodies (DLB).

Methods: We used a new-user active comparator design in the Merative Marketscan database to identify men with no history of DLB who were newly started on Tz/Dz/Az or 2 comparator medications. Our comparator medications were other drugs commonly used to treat benign prostatic hyperplasia that do not increase ATP: the α-1 adrenergic receptor antagonist tamsulosin or 5α-reductase inhibitor (5ARI). We matched the cohorts on propensity scores and duration of follow-up. We followed up the matched cohorts forward to estimate the hazard of developing DLB using Cox proportional hazards regression.

Results: Men who were newly started on Tz/Dz/Az had a lower hazard of developing DLB than matched men taking tamsulosin (n = 242,716, 728,256 person-years, hazard ratio [HR] 0.60, 95% CI 0.50-0.71) or 5ARI (n = 130,872, 399,316 person-years, HR 0.73, 95% CI 0.57-0.93). while the hazard in men taking tamsulosin was similar to that of men taking 5ARI (n = 159,596, 482,280 person-years, HR 1.17, 95% CI 0.96-1.42). These results were robust to several sensitivity analyses.

Discussion: We find an association in men who are taking Tz/Dz/Az and a lower hazard of DLB compared with similar men taking other medications. When combined with the literature of Tz/Dz/Az on Parkinson disease, our findings suggest that glycolysis-enhancing drugs may be broadly protective in neurodegenerative synucleinopathies. A future randomized trial is required to assess these associations for causality.

Classification of evidence: This study provides Class III evidence that Tz/Dz/Az use reduces the rate of developing DLB in adult men.

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