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Drugs used to treat prostate enlargement may reduce men’s risk of developing Parkinson disease.
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Approximately 0.4% of Canadians are affected by Parkinson disease—a progressive disorder that affects movement, balance and coordination. The risk for developing Parkinson disease increases with age.

A recent study led by Dr. Connie Marras, Clinician Scientist at the Krembil Research Institute, and Dr. Priti Gros, Clinical Fellow at Toronto Western Hospital, suggests that certain drugs used to treat prostate conditions may help to reduce men’s risk of Parkinson disease.

The researchers examined data from various provincial and federal databases to identify adult males who were prescribed drugs to treat prostate enlargement, a noncancerous condition that interferes with urination.

Between 1997 and 2019, 265,745 males in Ontario filled prescriptions for at least one of four drugs commonly used to treat prostate enlargement: terazosin, doxazosin, alfuzosin and tamsulosin. The first three of these drugs are known as phosphoglycerate kinase 1 (PGK1) activators, a class of drugs that improve the way cells manage energy.

“Previous research suggests that PGK1 activators have protective effects on the brain in experimental models of Parkinson disease,” explains Dr. Marras. “This may be because they improve the way that cells manage energy, and Parkinson disease is associated with impaired energy management in brain cells. We wanted to know if continued use of these drugs is associated with fewer new cases of Parkinson disease in the adult male population. We also wanted to see if the effects of these drugs differ from that of tamsulosin, a non-PGK1 activator.”

The researchers found that sustained use of all four drugs was associated with a lower risk of developing Parkinson disease in men over the age of 66. PGK1 activators were associated with a 6% reduction in disease incidence per year of use, and tamsulosin was associated with an 8% reduction per year of use.

“We found that regular use of PGK1 activators, as well as tamsulosin, was associated with reductions in the incidence of Parkinson disease. Further clinical studies are needed to determine how each of these drugs reduces an individual’s risk for developing Parkinson disease, and whether they may also be useful for treating the disease after it has developed,” says Dr. Marras.

This work was supported by ICES, the Bresler Family Research Fund and the UHN Foundation.

Gros P, Wang X, Guan J, Lang AE, Austin PC, Welk B, Visanji NP, Marras C. Exposure to Phosphoglycerate Kinase 1 Activators and Incidence of Parkinson's Disease. Mov Disord. 2021 Jul 9. doi: 10.1002/mds.28712.

Dr. Connie Marras (L) is a Clinician Scientist at the Krembil Research Institute and the senior author of the study; Dr. Priti Gros (R) is a Clinical Fellow at Toronto Western Hospital and the lead author of the study.