STUDY QUESTION: Do @entity1 starting treatment with prostate-specific a antagonists have increased risk of fall and @entity174 ? METHODS: Administrative datasets from the province of Ontario, Canada, that contain @entity1 level data were used to generate a cohort of 147   084 @entity1 aged >= 66 years who filled their first outpatient prescription for prostate-specific a antagonists @entity9940 , @entity31503 , or @entity6731 between June 2003 and December 2013 (exposed @entity1 ) plus an equal sized cohort matched 1:1 (using a propensity score model) who did not initiate a antagonist therapy. The primary outcome was a hospital emergency room visit or inpatient admission for a fall or @entity174 in the 90 days after exposure. STUDY ANSWER AND LIMITATIONS: The @entity1 exposed to prostate-specific a antagonist had significantly increased risks of falling (odds ratio 1.14 (95% CI 1.07 to 1.21), absolute risk increase 0.17% (0.08 to 0.25%)) and of sustaining a @entity174 (odds ratio 1.16 (1.04 to 1.29), absolute risk increase 0.06% (0.02 to 0.11%)) compared with the unexposed cohort. This increased risk was not observed in the period before a antagonist use. Secondary outcomes of @entity551 and @entity542 were also significantly increased in the exposed cohort (odds ratios 1.80 (1.59 to 2.03) and 1.15 (1.04 to 1.27) respectively). The two cohorts were similar across 98 different covariates including demographics, comorbid conditions, medication use, healthcare use, and prior medical investigation. Potential unmeasured confounders, such as physical deconditioning, @entity73 , and situational risk factors, may exist. The data used to identify the primary outcomes had limited sensitivity, so the absolute risks of the outcomes are probably underestimates. The study only included @entity1 >= 66 years old, and 84% of exposed @entity1 were prescribed @entity9940 , so results may not be generalizable to younger @entity1 , and there may not be statistical power to show small differences in outcomes between the drugs. WHAT THIS STUDY ADDS: Prostate-specific a antagonists are associated with a small but significant increased risk of fall, @entity174 , and @entity542 , probably as a result of induced @entity551 . FUNDING, COMPETING INTERESTS, DATA SHARING: This project was conducted at the Institute for Clinical Evaluative Sciences (ICES) Western Site through the Kidney, Dialysis, and Transplantation (KDT) research program. BW has received a research grant from Astellas, and L-AF does consultancy for Amgen.

The risk of fall and XXXX with the initiation of a prostate-selective a antagonist: a population based cohort study.

@entity1 :: ('9606', 'Species') :: ['men', 'patient'] @entity6731 :: ('MESH:C095285', 'Chemical') :: ['silodosin'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fracture'] @entity73 :: ('MESH:D003072', 'Disease') :: ['mobility impairment'] @entity542 :: ('MESH:D006259', 'Disease') :: ['head trauma'] @entity31503 :: ('MESH:C047638', 'Chemical') :: ['alfuzosin'] @entity551 :: ('MESH:D007022', 'Disease') :: ['hypotension'] @entity9940 :: ('MESH:C088482', 'Chemical') :: ['tamsulosin']
@entity174 :: (MESH:D050723,Disease) :: ['fracture']
