Medication background of Japanese men undergoing prostate needle biopsy: A medication profile based on the number of medications and drug classes

Prostate cancer is common in older men, and the treatment decision depends strongly on the patient's general condition and comorbidities. However, the medication background of men who reach prostate biopsy has rarely been described. We used a large Japanese administrative claims database (Medical Data Vision) to profile the medications of men who underwent prostate needle biopsy between April 2008 and June 2019. We examined the number of medications and the drug classes in relation to body mass index (BMI) and age. We identified 67,812 men, all aged 60 years or older. The mean number of medications was lowest at BMI 20-25 and increased toward both low and high BMI, showing a U-shaped pattern (minimum 1.44 drugs at BMI 22.0-22.5); the increase was driven mainly by high BMI. This pattern was consistent across age strata, and in a negative binomial regression adjusted for age the quadratic term of BMI remained significant (p < 0.001), with an adjusted minimum at BMI 20.5. The composition of drug classes differed by body size: metabolic drugs (antihypertensive/cardiovascular, dyslipidemia, diabetes, and hyperuricemia drugs) were more common at high BMI, whereas gastrointestinal and analgesic drugs were relatively more common at low BMI, and all classes increased with age. In conclusion, among men undergoing prostate biopsy, the number of medications was lowest at BMI 20-25 and the qualitative medication profile differed by BMI. These findings describe the medication background of this population and may inform the design of future risk-stratified or prospective studies.