양성전립선비대증 증상 조절을 위해 투여되는 알파차단제의 골절위험

이중엽; 최남경; 정선영; 오승준; 박병주; 김예지; 성종미

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자료유형: 학술저널

저자정보: 이중엽 최남경 정선영 오승준 박병주 김예지 성종미

저널정보: 대한예방의학회 예방의학회지 예방의학회지 제42권 제3호

발행연도: 2009.1

수록면: 165 - 170 (6page)

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Objectives : We evaluated the risk of fracture associated with hypotension-related adverse drug reaction caused by taking alpha blockers to treat benign prostatic hyperplasia (BPH). Methods : We used the Health Insurance Review and Assessment Service database from January 1st 2005 to June 30th 2006 for this study. The male patients with BPH and who had a prescription for alpha blockers following any fractures were defined as the cases. We set the 20 day long hazard period prior to the index date and the four control periods whose lengths were same with hazard period. After 1:4 matching of the hazard and control periods, conditional logistic regression was used to calculate the odds ratios for the risk of fractures as related to the alpha blocker exposure. Results : Doxazosin and tamsulosin showed the increased risk of fractures, whereas terazosin did not. After stratification using the defined daily doses, a protective effect was shown for the patients who took terazosin at the doses lower than 0.4 DDD and the hazardous effect at the doses higher than or equal to 0.4 DDD. There was no significant difference for the risk of patients taking tamsulosin at the doses higher than 1.0 DDD but there was a statistically significant increase in the risk at the doses higher than or equal to 1.0 DDD. Conclusions : Alpha blockers for BPH may increase the risk of fracture in elderly patients who have comorbidities and take the concomitant medications. Alpha blockers need to be prescribed with caution, although some have high prostate specificity.

#Benign prostatic hyperplasia #Adrenergic alpha antagonist #Adverse drug reactions #Fracture #Case-crossover study

참고문헌 (17)

참고문헌 신청

AUA Practice Guidelines Committee / 2003 / Guideline on the management of benign prostatic hyperplasia / J Urol 170 (2 Pt 1) : 530 ~ 547

Arrighi HM / 1991 / Natural history of benign prostatic hyperplasia and risk of prostatectomy / Urology 38 (1) : 4 ~ 8

Chrischilles E / 2001 / Initiation of nonselective alpha1 antagonist therapy and occurrence of hypotension-related adverse events among men with benign prostatic hyperplasia:

Djavan B / 2004 / State of the art on the efficacy and tolerability of the alpha1-adrenoceptor antagonists in patients with lower urinary tract symptoms suggestive of benign

Hall GC / 2007 / Comparative study of modified release alpha blocker exposure inelderly patients with fractures / Pharmacoepidemiol Drug Saf 16 (8) : 901 ~ 907

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