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Spironolactone - A Hypertension Diuretic Drug Reduces Prostate Cancer Risk

Spironolactone - A Hypertension Diuretic Drug Reduces Prostate Cancer Risk

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Highlights :
  • Spironolactone reduces prostate cancer risk by 17%
  • Spironolactone is a hypertension drug with anti-androgenic properties
  • Spironolactone has a dose-dependent risk reduction of prostate cancer
  • Spironolactone has no statistical significance in low risk and advanced/ metastatic disease risk groups.

Spironolactone is a well-known water or diuretic pill that spares the potassium from excreting from your body but lets the sodium pass out of the body.

Spironolactone is and frequently used to treat heart failure and high blood pressure. It is also used where the potassium levels are low in the blood. The pill is also known to have anti-androgenic properties that may help reduce the risk of prostate cancer.


Spironolactone - A Hypertension Diuretic Drug Reduces Prostate Cancer Risk

A group of researchers studied the association of spironolactone in prostate cancer and found that spironolactone results in a 17% reduced risk of prostate cancer. In the study, the thiazide pill used in another arm as it also is a diuretic but does not have anti-androgenic properties.

The research findings were published in the journal Prostate Cancer and Prostate Diseases.

How Does Spironolactone Work?

Spironolactone acts by blocking a hormone called aldosterone in the kidney and it regulates the salt and water balance in the body. The pill is useful in the treatment of resistant hypertension.

It is also used in cases to treat edema (swelling), nephrotic syndrome and liver cirrhosis

What is Prostate Cancer?

The prostate is a small walnut-shaped gland that is present in the pelvis of men. Prostate cancer is a type of cancer that develops in the prostate gland.

Prostate cancer is the second leading cause of cancer death for men in the United States. Around 1 in 9 men are also believed to be diagnosed with prostate cancer during their lifetime.

What is the Link between Spironolactone and Prostate Cancer?

A large group of men with prostate cancer require management of hypertension. Due to its anti-androgenic properties, spironolactone may affect prostate cancer risk and progression.

Spironolactone because of its anti-androgenic properties binds non-selectively to other steroid receptors, including progesterone and androgen receptors.

How was the Study Conducted?

The researchers undertook a matched case-control study by using data from the Prostate Cancer data Base Sweden (PCBaSe).

All men diagnosed between 2014 and 2016 were matched by birth year and county with prostate cancer-free controls selected from the general population (1:5).

The study group was divided into categories based on risk; low risk, intermediate risk, high risk, regional/metastatic disease.

Multivariable conditional logistic regression was used to estimate the risk of prostate cancer when spironolactone was prescribed based on duration and dose. The same method was applied to thiazides.

What are the Results Obtained from the Study?

The study population contained 31,591 men with prostate cancer, and 156,802 prostate free controls.

Four percent of the controls (5571) were prescribed with spironolactone and were compared with three percent (846) of the cases.

Three percent of both the cases and controls were prescribed with thiazide.

Multivariable analyses indicated a reduced risk of prostate cancer in people exposed to spironolactone. A stronger association of reduced risk of prostate cancer was seen in current users than past users of spironolactone.

A direct dose-dependent decrease in prostate cancer was observed, meaning an increase in dose resulted in a decrease in the risk of prostate cancer. However, spironolactone exposure association with prostate cancer was not statistically significant in low-risk and advanced/ metastatic disease risk populations.

Risk reduction of prostate cancer was also equal between symptomatic and asymptomatic patients.

No association was observed between thiazide exposure and prostate cancer risk.

Overall, a 17% reduced risk of prostate cancer was observed when men were prescribed with spironolactone. Further investigation of spironolactone's potential chemopreventive effects is warranted.

Reference :
  1. Spironolactone use is associated with lower prostate cancer risk: a population-wide case-control study - (https://doi.org/10.1038/s41391-020-0220-8)

Source: Medindia

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