Related Experiment Video
Updated: Jun 26, 2025
A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
Published on: March 6, 2018
Prostate cancer incidence and mortality in men exposed to α1-adrenergic receptor antagonists
Lars Björnebo1, Shirin Razdan2, Andrea Discacciati1
1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Background:
α1-Adrenergic receptor antagonists are commonly used to treat benign prostatic hyperplasia. Preclinical studies suggest that they induce cell death and inhibit tumor growth. This study evaluated the risk of prostate cancer death in men using α1-adrenergic receptor antagonists.
Methods:
A population-based cohort study in Stockholm, Sweden (January 1, 2007, to December 31, 2019) included 451 779 men with a prostate-specific antigen test result. Study entry was 1 year after the first prostate-specific antigen test. Men were considered exposed at their second filled prescription. The primary outcome was prostate cancer mortality. Secondary outcomes were all-cause mortality and prostate cancer incidence. Cox proportional hazards regression models were used to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for all outcomes. Inverse-probability weighting with marginal structural models accounted for time-dependent confounders.
Results:
Of 351 297 men in the final cohort, 39 856 (11.3%) were exposed to α1-adrenergic receptor antagonists. Median (interquartile range) follow-up for prostate cancer mortality was 8.9 (5.1-10.9) years; median (interquartile range) exposure time to α1-adrenergic receptor antagonists was 4.4 (2.0-7.6) years. There was no evidence of an association between α1-adrenergic receptor antagonist use and prostate cancer mortality, all-cause mortality, or high-grade prostate cancer. α1-Adrenergic receptor antagonist use was associated with an increased risk of prostate cancer (HR = 1.11, 95% CI = 1.06 to 1.17) and low-grade prostate cancer (HR = 1.22, 95% CI = 1.11 to 1.33). Men whose prostate cancer was treated with α1-adrenergic receptor antagonists underwent more frequent prostate-specific antigen testing.
Conclusions:
Our findings show no significant association between α1-adrenergic receptor adrenoceptor antagonist exposure and prostate cancer mortality or high-grade prostate cancer. Although the preclinical evidence indicates a potential chemopreventive effect, this study's findings do not support it.
Insights
Alpha-1 adrenergic receptor antagonists do not increase prostate cancer death risk. However, their use was linked to a higher incidence of overall and low-grade prostate cancer, not supporting preclinical chemopreventive effects.
Area of Science:
- Urology
- Oncology
- Pharmacology
Background:
- Alpha-1 adrenergic receptor antagonists are prescribed for benign prostatic hyperplasia.
- Preclinical research suggests these drugs may inhibit tumor growth and induce cell death.
- The study investigated the association between alpha-1 adrenergic receptor antagonist use and prostate cancer mortality.
Purpose of the Study:
- To evaluate the risk of prostate cancer death in men using alpha-1 adrenergic receptor antagonists.
- To assess the impact of these antagonists on all-cause mortality and prostate cancer incidence.
Main Methods:
- A population-based cohort study in Stockholm, Sweden, from 2007 to 2019.
- Included over 350,000 men with prostate-specific antigen (PSA) test results.
- Used Cox proportional hazards regression and inverse-probability weighting to analyze prostate cancer mortality, all-cause mortality, and cancer incidence.
Main Results:
- No association was found between alpha-1 adrenergic receptor antagonist use and prostate cancer mortality, all-cause mortality, or high-grade prostate cancer.
- A statistically significant increase in the risk of overall prostate cancer (HR=1.11) and low-grade prostate cancer (HR=1.22) was observed with antagonist use.
- Men treated with these antagonists had more frequent PSA testing.
Conclusions:
- The study findings do not support a chemopreventive effect of alpha-1 adrenergic receptor antagonists against prostate cancer.
- There is no evidence that alpha-1 adrenergic receptor antagonist use increases the risk of prostate cancer death or high-grade disease.
- Further research may be needed to understand the observed association with low-grade prostate cancer incidence.
Related Concept Videos
01:22Adrenergic Antagonists: Pharmacological Actions of ɑ-Receptor Blockers
α1-blockers: These drugs inhibit α1-adrenoceptors on smooth muscle cells, resulting in vasodilation. This vasodilation lowers blood pressure, making α1-blockers valuable in treating hypertension. Additionally,...
01:31Adrenergic Receptors: ɑ Subtype
Adrenaline ≥ Noradrenaline >> Isoprenaline
α-adrenoceptors are further divided into α1 and α2-adrenoceptors.
α1-Adrenoceptors: These receptors are located postsynaptically on the effector organs and cause constriction of smooth muscle mediated by activation of phospholipase...
01:17Adrenergic Antagonists: Chemistry and Classification of ɑ-Receptor Blockers
Nonselective α-blockers: Nonselective α-blockers contain haloalkylamine or imidazoline...
01:20Disorders of the Male Reproductive System
Prostate disorders are another major concern. These conditions can impair urinary flow due to the prostate's location around the urethra....
01:26Adrenergic Receptors: β Subtype
Isoprenaline > Adrenaline > Noradrenaline
Neurotransmitter binding to these receptors causes activation of adenylyl cyclase resulting in increased concentrations of cAMP and modulation of calcium ion channels within the cell. They are further classified into β1, β2, and β3 subtypes.
β1-adrenoceptors: β1-adrenoceptors...
01:31Adrenergic Antagonists: ɑ and β-Receptor Blockers