Prostate treatments useful in Parkinson's disease?

Certain drugs currently used to treat benign prostatic hyperplasia (BPH) may provide neuroprotection and delay or prevent the onset of Parkinson's disease.

Treatment of BPH with terazosin (Hytrin), doxazosin (Cardura), or alfuzosin (Uroxatral), all of which enhance glycolysis, was associated with a lower risk of developing Parkinson's disease than patients taking a drug used for the same indication, tamsulosin (Flomax), which doesn't affect glycolysis.

The pathogenesis of Parkinson's disease is heterogeneous, however, and not all patients may benefit from glycolysisenhancing drugs.

Future research will be needed to identify potential candidates for this treatment, and clarify the effects of these drugs.

The findings were published online February 1 in JAMA Neurology.

The major risk factor for Parkinson's disease is age, which is associated with impaired energy metabolism. Glycolysis is decreased among patients with Parkinson's.

The investigators used healthcare utilization data from Denmark and the United States, including the Danish National Prescription Registry, the Danish National Patient Registry, the Danish Civil Registration System, and the Truven Health Analytics MarketScan database.

Among Danish patients, those who took terazosin, doxazosin, or alfuzosin had a lower risk of developing Parkinson's vs those who took tamsulosin (hazard ratio [HR], 0.88). Similarly, patients in the Truven database who took terazosin, doxazosin, or alfuzosin had a lower risk of developing Parkinson's than those who took tamsulosin (HR, 0.63).

In both cohorts, the risk for Parkinson's among patients receiving terazosin, doxazosin, or alfuzosin, compared with those receiving tamsulosin, decreased with increasing numbers of prescriptions filled. Long-term treatment with any of the three glycolysis-enhancing drugs was associated with greater risk reduction in the Danish (HR, 0.79) and in the Truven (HR, 0.46) cohorts, vs tamsulosin.