Use of Glycolysis Enhancing Drugs has Less Risk of Parkinson's Disease than 5α-reductase Inhibitors


Background: Terazosin and closely related α1-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 Parkinson’s disease. We consider a different comparison group of men taking the 5α-reductase inhibitors 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 5α-reductase inhibitors. We followed these matched cohorts to compare the hazard of developing Parkinson’s disease.

Results: We found that men taking TZ/DZ/AZ had a lower hazard of Parkinson’s disease than men taking tamsulosin (HR=0.72, 95% CI: 0.66-0.78, n=239,946) and lower than men taking a 5α-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 5α-reductase inhibitors (HR=1.10, 95% CI: 1.00-1.22, n=157,490).

Conclusions: These data suggest that men using TZ/DZ/AZ have a lower risk of developing Parkinson’s disease than those using tamsulosin or 5α-reductase inhibitors while users of tamsulosin and 5α-reductase inhibitors have relatively similar survival functions.

Jacob Simmering
Jacob Simmering
Assistant Professor of Internal Medicine

Health, data, and statistics.