Use of glycolysis enhancing drugs has less risk of Parkinson's disease than 5α-reductase inhibitors

BackgroundTerazosin and closely related 1-adrenergic receptor antagonists (doxazosin and alfuzosin; TZ/DZ/AZ) enhance glycolysis and reduce neurodeneration in animal models. Observational evidence in humans from several databases support this finding; however, a recent study has suggested that tamsulosin, the comparator medication, increases risk of Parkinsons disease. We consider a different comparison group of men taking 5-reductase inhibitors as a new, independent comparison allowing us to both obtain new estimates of the association between TZ/DZ/AZ and Parkinsons disease outcomes and validate tamsulosin as an active comparator. MethodsUsing the Truven Health Analytics Marketscan database, we identified men without Parkinsons disease, newly started on TZ/DZ/AZ, tamsulosin, or 5-reductase inhibitors. We followed these matched cohorts to compare the hazard of developing Parkinsons disease. ResultsWe found that men taking TZ/DZ/AZ had a lower hazard of Parkinsons disease than men taking tamsulosin (HR=0.72, 95% CI: 0.66-0.78, n=239,946) and lower than men taking a 5-reductase inhibitors (HR=0.81, 95% CI: 0.72-0.92, n=129,320). The hazard for men taking tamsulosin was not statistically significantly different than for men taking 5-reductase inhibitors (HR=1.10, 95% CI: 1.00-1.22, n=157,490). ConclusionsThese data suggest that men using TZ/DZ/AZ have a lower risk of developing Parkinsons disease than those using tamsulosin or 5-reductase inhibitors while users of tamsulosin and 5-reductase inhibitors have relatively similar survival functions.