Jacob Simmering is an assistant professor in the Division of Pulmonary, Critical Care, and Occupational Medicine at the University of Iowa. My graduate school training was a mixture of epidemiology, health economics, and statistical methods and current areas of active research include the effects of the environment, especially weather and pollution, on health outcomes and pharmacoepidemiology and neurodegenerative diseases.
My non-research interests include wondering about the effects of the built environment in cities, biking, reading, his toddler, doomscrolling on Twitter, and saying that I’ll someday learn Julia.
PhD in Health Services Research, 2016
University of Iowa College of Pharmacy
MS in Epidemiology, 2009
University of Iowa College of Public Health
BA in Chemistry, 2009
Background: Terazosin (TZ) and closely related α1-adrenergic receptor antagonists (doxazosin [DZ] and alfuzosin [AZ]) enhance glycolysis and reduce neurodegeneration in animal models. Observational evidence in humans from several databases supports this finding; however, a recent study has suggested that tamsulosin, the comparator medication, increases the risk of Parkinson’s disease. Aims: We consider a different comparison group of men taking 5α-reductase inhibitors (5ARIs) as a new, independent comparison allowing us to both obtain new estimates of the association between TZ/DZ/AZ and Parkinson’s disease outcomes and validate tamsulosin as an active comparator. Methods: Using the Truven Health Analytics Marketscan database, we identified men without Parkinson’s disease, newly started on TZ/DZ/AZ, tamsulosin, or 5ARIs. We followed these matched cohorts to compare the hazard of developing Parkinson’s disease. We conducted sensitivity analyses using variable duration of lead-in to mitigate biases introduced by prodromal disease. Results: We found that men taking TZ/DZ/AZ had a lower hazard of Parkinson’s disease than men taking tamsulosin (hazard ratio (HR) =0.71, 95% CI [confidence interval]: 0.65–0.77, n = 239,888) and lower than men taking 5ARIs (HR = 0.84, 95% CI: 0.75–0.94, n = 129,116). We found the TZ/DZ/AZ versus tamsulosin HR to be essentially unchanged with up to 5 years of lead-in time; however, the TZ/DZ/AZ versus 5ARI effect became attenuated with longer lead-in durations. Conclusions: These data suggest that men using TZ/DZ/AZ have a somewhat lower risk of developing Parkinson’s disease than those using tamsulosin and a slightly lower risk than those using 5ARIs.
Enough to Be Dangerous
At least 30
2.5 Years Since Last Road Rash