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International cohort study indicates no association between alpha-1 blockers and susceptibility to COVID-19 in benign prostatic hyperplasia patients

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dc.contributor.authorNishimura, A.
dc.contributor.authorXie, J.
dc.contributor.authorKostka, K.
dc.contributor.authorDuarte-Salles, T.
dc.contributor.authorFernández Bertolín, S.
dc.contributor.authorAragón, M.
dc.contributor.authorBlacketer, C.
dc.contributor.authorShoaibi, A.
dc.contributor.authorDuVall, S.L.
dc.contributor.authorLynch, K.
dc.contributor.authorMatheny, M.E.
dc.contributor.authorFalconer, T.
dc.contributor.authorMorales, D.R.
dc.contributor.authorConover, M.M.
dc.contributor.authorChan You, S.
dc.contributor.authorPratt, N.
dc.contributor.authorWeaver, J.
dc.contributor.authorSena, A.G.
dc.contributor.authorSchuemie, M.J.
dc.contributor.authorReps, J.
dc.contributor.authoret al.
dc.date.issued2022
dc.descriptionData source: Supplementary material, https://doi.org/10.3389/fphar.2022.945592
dc.description.abstract<b>Purpose:</b> Alpha-1 blockers, often used to treat benign prostatic hyperplasia (BPH), have been hypothesized to prevent COVID-19 complications by minimising cytokine storm release. The proposed treatment based on this hypothesis currently lacks support from reliable real-world evidence, however. We leverage an international network of large-scale healthcare databases to generate comprehensive evidence in a transparent and reproducible manner. <b>Methods:</b> In this international cohort study, we deployed electronic health records from Spain (SIDIAP) and the United States (Department of Veterans Affairs, Columbia University Irving Medical Center, IQVIA OpenClaims, Optum DOD, Optum EHR). We assessed association between alpha-1 blocker use and risks of three COVID-19 outcomes-diagnosis, hospitalization, and hospitalization requiring intensive services-using a prevalent-user active-comparator design. We estimated hazard ratios using state-of-the-art techniques to minimize potential confounding, including large-scale propensity score matching/stratification and negative control calibration. We pooled database-specific estimates through random effects meta-analysis. <b>Results:</b> Our study overall included 2.6 and 0.46 million users of alpha-1 blockers and of alternative BPH medications. We observed no significant difference in their risks for any of the COVID-19 outcomes, with our meta-analytic HR estimates being 1.02 (95% CI: 0.92-1.13) for diagnosis, 1.00 (95% CI: 0.89-1.13) for hospitalization, and 1.15 (95% CI: 0.71-1.88) for hospitalization requiring intensive services. <b>Conclusion:</b> We found no evidence of the hypothesized reduction in risks of the COVID-19 outcomes from the prevalent-use of alpha-1 blockers-further research is needed to identify effective therapies for this novel disease.
dc.identifier.citationFrontiers in Pharmacology, 2022; 13(945592)
dc.identifier.doi10.3389/fphar.2022.945592
dc.identifier.issn1663-9812
dc.identifier.issn1663-9812
dc.identifier.orcidPratt, N. [0000-0001-8730-8910]
dc.identifier.urihttps://hdl.handle.net/11541.2/31158
dc.language.isoen
dc.publisherFRONTIERS MEDIA SA
dc.relation.fundingNHMRC 1157506
dc.relation.fundingUS Food and Drug Administration
dc.relation.fundingNational Institute of Health HHS-FDA 75F40120D00039
dc.relation.fundingHealth Department from the Generalitat de Catalunya
dc.relation.fundingKantar Health
dc.relation.fundingWellcome Trust Clinical Research Career Development Fellowship
dc.relation.fundingUS National Institutes of Health
dc.relation.fundingNIHR Senior Research Fellowship R01 LM006910
dc.relation.fundingBill and Melinda Gates Foundation SRF-2018-11-ST2-004
dc.relation.fundingUK National Institute for Health Research INV016201
dc.rightsCopyright 2022 The author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. (https://creativecommons.org/licenses/by/4.0/)
dc.source.urihttps://doi.org/10.3389/fphar.2022.945592
dc.subjecttreatment for SARS CoV-2
dc.subjectobservational study
dc.subjectelectronic health records
dc.subjectfederated data model
dc.subjectcausal inference
dc.subjectopen science
dc.titleInternational cohort study indicates no association between alpha-1 blockers and susceptibility to COVID-19 in benign prostatic hyperplasia patients
dc.typeJournal article
pubs.publication-statusPublished
ror.fileinfo12252318940001831 13252318930001831 fphar-13-945592
ror.mmsid9916687418901831

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