This report examines the 4-year longitudinal association between histological prostate inflammation and CP/CPPS, development of new and progression of existing CP/CPPS, in the men randomized to placebo in the REDUCE population.
Uni- and multivariable analyses at multiple time points over 4 years were performed between acute and chronic inflammation detected on baseline biopsies and incidence of CPPS-like symptoms (defined as a positive response to CPSI question 1a [perineal pain] and/or question 2b [ejaculatory pain], and a total pain subscore of at least 4) and progression of CP/CPPS (defined as an increase ≥ 4 points from baseline total CPSI score in patients with a baseline categorization of CP/CPPS).
Acute and chronic inflammation was detected in 641 (15.6%) and 3216 (78.3%) of the 4109 men in the study. CP/CPPS symptom status was available for 2816 at baseline. A total of 317 of the 2150 men with no baseline CP/CPPS and follow-up data developed CP/CPPS - like symptoms. Acute and chronic inflammation was not associated with the incidence of CP/CPPS like symptoms (p> 0.1). After a median follow-up of 12.0 months, a total of 109 of the 145 men baseline CP/CPPS and follow-up data developed symptomatic progression. Chronic, but not acute, inflammations was significantly associated with a shorter time to CP/CPPS progression in both uni- or multivariable analyses (p=0.029 and 0.018 respectively).
Inflammation is not associated with an increased risk of developing CP/CPPS but chronic inflammation does predict risk of symptomatic progression in men who have identified CP/CPPS symptoms.
The Journal of urology. 2017 Jan 12 [Epub ahead of print]
J Curtis Nickel, Stephen J Freedland, Ramiro Castro-Santamaria, Daniel M Moreira
Department of Urology, Queen's University, Kingston, ON, Canada; Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA; GlaxoSmithKline Inc., Global R&D, King of Prussia, PA, USA; Department of Urology, University of Illinois at Chicago, Chicago, USA.