Evidence map›Paper›PMID 42547757›Full record

ArticleDiabetes, obesity & metabolism2026

Absence of Interaction Between 5α-Reductase Inhibitors and Glucocorticoids on Incidence of Myocardial Infarction in People With Type 2 Diabetes.

Haolan Tu, Chengsheng Ju, Stuart J McGurnaghan, Luke A K Blackbourn, Scottish Diabetes Research Network Epidemiology Group, Ewan R Pearson, Li Wei, Ruth Andrew

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Article in Diabetes, obesity & metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Haolan TuInstitute of Neuroscience and Cardiovascular Research, University of Edinburgh, Edinburgh, UK.
Chengsheng JuSchool of Pharmacy, University College London, London, UK.
Stuart J McGurnaghanMRC Unit for Human Genetics, University of Edinburgh, Edinburgh, UK.
Luke A K BlackbournMRC Unit for Human Genetics, University of Edinburgh, Edinburgh, UK.
Scottish Diabetes Research Network Epidemiology GroupMRC Unit for Human Genetics, University of Edinburgh, Edinburgh, UK.
Ewan R PearsonSchool of Medicine, University of Dundee, Dundee, UK.
Li WeiSchool of Pharmacy, University College London, London, UK.
Ruth AndrewInstitute of Neuroscience and Cardiovascular Research, University of Edinburgh, Edinburgh, UK.ORCID 0000-0002-6916-2994

Funding

Medical Research Council MR/W006804/1UK Research and Innovation
6 · The paper itself

Abstract

aimsPeople with Type 2 diabetes experience higher cardiometabolic risk, and both synthetic glucocorticoids and use of 5α-reductase inhibitors have been individually linked to increased risk of myocardial infarction. We tested whether the increase in risk is exacerbated by co-prescription of both drugs. MATERIALS AND

methodsWe performed a population-based cohort study in the Scottish Diabetes Research Network-National Diabetes Dataset (SDRN-NDS) and IQVIA Medical Research Data-UK (IMRD-UK). Patients with Type 2 diabetes aged ≥ 40 years receiving 5α-reductase inhibitors or tamsulosin, who were incident users of systemic glucocorticoids during 2006-2021 were included. We modelled the joint effect of 5α-reductase inhibitors and cumulative exposure to glucocorticoids on the risk of myocardial infarction using a time-varying Cox proportional hazards model.

resultsA total of 13 161 patients with Type 2 diabetes were included in SDRN-NDS and 15 084 in IMRD-UK. Mean age was 71.4 ± 9.6 and 72.3 ± 9.4 years, with mean follow-up of 4.7 (3.6) and 5.6 (4.0) years, respectively. Median (IQR) total glucocorticoids exposure was 210 (96-630) and 420 (200-1240) prednisolone-equivalent milligram. Risk for myocardial infarction was increased among users of 5α-reductase inhibitors (HR [95% CI]: SDRN-NDS, 1.21 [1.02-1.43]; IMRD-UK, 1.27 [1.02-1.59]) and per SD increase in cumulative glucocorticoid exposure (HR [95% CI]: SDRN-NDS, 1.09 [1.03-1.14]; IMRD-UK, 1.08 [1.01-1.15]). We did not observe a multiplicative interaction (SDRN-NDS, p = 0.44; IMRD-UK, p = 0.68) between the use of the two drugs.

conclusionPeople with Type 2 diabetes exposed to 5α-reductase inhibitors or glucocorticoids are at an increased risk of myocardial infarction, although a multiplicative interaction between the use of the two drugs was not found.

Indexed as

5-alpha Reductase InhibitorsDiabetes Mellitus, Type 2GlucocorticoidsMyocardial InfarctionAgedAged, 80 and overCohort StudiesDrug InteractionsFemaleHumansIncidenceMaleMiddle AgedProportional Hazards ModelsRisk FactorsScotland5-alpha Reductase InhibitorsGlucocorticoidscardiovascular diseasemacrovascular diseaseobservational studyreal‐world evidenceType 2 diabetes

Identifiers

PMID42547757
PMCPMC13538775

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.