5α-Reductase Inhibitors are Associated with Reduced Risk of SARS-COV-2 Infection

[pjoshea13]

New Cleveland Clinic study below. [1]

Note: 5α-Reductase Inhibitors [5ARIs] - such as Dutasteride [Avodart] - inhibit the conversion of testosterone to dihydrotestosterone [DHT].

"SARS-CoV-2 has a disproportionately severe effect on men, suggesting that the androgen pathway plays a role in the disease. Studies on the effect of castration and androgen receptor (AR) blockade have been mixed "

{Time to retire the idea that ADT is reliably protective.}

"60,474 males in a prospective registry of people tested for SARS-CoV-2 between March 8, 2020-February 15, 2021 were included."

"1079 men (1.8%) reported 5ARI use, and 55,100 were available for matching. The final matched cohorts included 944 men each. Mean duration of use was 60.4 months (IQR 17-84 months). Absolute risk for infection was significantly lower in 5ARI users compared to nonusers, 42.3% ... vs. 47.2%"

"Use of 5ARIs in men without prostate cancer was associated with a reduction in community acquired SARS-CoV-2 infection."

-Patrick

[1] pubmed.ncbi.nlm.nih.gov/344...

J Urol

. 2021 Aug 26;101097JU0000000000002180. doi: 10.1097/JU.0000000000002180. Online ahead of print.

5α-Reductase Inhibitors are Associated with Reduced Risk of SARS-COV-2 Infection: A Matched-Pair, Registry-Based Analysis

Madison Lyon 1 , Jianbo Li 2 , Jennifer Cullen 3 , Alex Milinovich 2 , Michael Kattan 2 , Lara Jehi 4 , Nima Sharifi 5 , Eric A Klein 1

Affiliations collapse

Affiliations

1 Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic.

2 Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic.

3 Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine.

4 Department of Neurology, Neurological Institute, Cleveland Clinic.

5 Genitourinary Malignancies Research Center, Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic.

PMID: 34433301 DOI: 10.1097/JU.0000000000002180

Abstract

Purpose: SARS-CoV-2 has a disproportionately severe effect on men, suggesting that the androgen pathway plays a role in the disease. Studies on the effect of castration and androgen receptor (AR) blockade have been mixed, while 5α-reductase inhibitor (5ARI) use in men with COVID-19 have shown potential benefits. We assessed the association of 5ARI use on risk of community acquired SARS-CoV-2 infection.

Materials and methods: 60,474 males in a prospective registry of people tested for SARS-CoV-2 between March 8, 2020-February 15, 2021 were included. Using a matched cohort design, men using 5ARIs were matched 1:1 to non-5ARI users. Independent analysis using unconditional multivariable logistic regression on the entire unmatched dataset was completed for validation. Primary outcome measures were the association of 5ARI use on rates of SARS-Cov-2 positivity and disease severity.

Results: 1079 men (1.8%) reported 5ARI use, and 55,100 were available for matching. The final matched cohorts included 944 men each. Mean duration of use was 60.4 months (IQR 17-84 months). Absolute risk for infection was significantly lower in 5ARI users compared to nonusers, 42.3% (399/944) vs. 47.2% (446/944), respectively (absolute risk reduction (ARR) 4.9%, OR 0.81, 95% CI 0.67-0.97, p=0.026). Unconditional multivariable logistic regression analysis of the entire study cohort of 55,100 men confirmed the protective association of 5ARI use (ARR 5.3%, OR=0.877, 95% CI 0.774-0.995, p=0.042). Use of 5ARIs was not associated with disease severity.

Conclusions: Use of 5ARIs in men without prostate cancer was associated with a reduction in community acquired SARS-CoV-2 infection.

Keywords: 5a-reductase inhibitors; COVID-19; SARS-CoV-2.

[EdBar]

Good to hear, I’ve been using Avodart for 7+ years now per Snuffy Myers. Every little bit helps.

Ed

[MateoBeach]

Very unconvincing: such a tiny difference after statistical “corrections”. And 5ARI use have been subject to selection bias of slightly more vulnerable group. And HR goes to .99. I’d consider that a non starter for protective effect.