The results of a large study of Avodart for the prevention of prostate cancer have revealed an altogether unexpected finding: the drug increases the risk for heart failure. Avodart is typically used to treat urinary symptoms caused by an enlarged prostate gland. Heart failure had not been noted when men use it for this purpose.
The study appears in the New England Journal of Medicine. It included 6,700 men that were between the ages of 50-75 and that had high PSA levels (PSA is a prostate cancer screening test) but no actual prostate cancer as revealed by a recent biopsy. Subjects were randomized to receive either Avodart or a placebo, and were re-biopsied after 4 years.
The new biopsies revealed cancer in 25% of subjects taking placebo, and 20% of those taking Avodart. Those findings match the cancer-preventing performance Merck’s Proscar, another urinary drug sold generically as finasteride, but the finasteride patients showed no signs of heart failure.
Heart failure developed in 30 men taking Avodart, compared with 16 men who received placebo.
Subset analyses showed that patients who developed heart failure tended to be taking other drugs which are known to precipitate heart failure, according to Glaxo spokesperson Sarah Alspach. The higher incidence of heart failure in the Avodart study “is unexpected and inconsistent” with previous research, she told AOLnews.
Last year, an expert panel recommended that men who are screened regularly for prostate cancer should consider taking Proscar or Avodart. It’s unclear whether the panel will revisit those recommendations in light of the new findings.
Both drugs cost about $3 per pill. To prevent one new case of cancer, 71 men would have to take Proscar for 7 years.
Prostate cancer is the most common non-skin cancer in US males. Roughly 192,000 new cases and 27,000 deaths were attributed to prostate cancer last year.