{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T17:03:29Z","timestamp":1788023009288,"version":"build-2784847793"},"reference-count":52,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T00:00:00Z","timestamp":1726531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern Med"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Tadalafil, commonly prescribed for benign prostatic hyperplasia (BPH), may benefit patients with Type 2 diabetes mellitus (T2DM) for glycemic markers and complications. However, the association between the long\u2010term use of tadalafil and the incidence of T2DM has not been investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We emulated a target trial of tadalafil use (5\u00a0mg\/day) and the risk of T2DM using a population\u2010based claims database in Japan. Patients who initiated tadalafil or alpha\u2010blockers for BPH and had no history of diabetes diagnosis, no dispensing of glucose\u2010lowering drugs, and no history of hemoglobin A1c levels of \u22656.5% (47\u201348\u00a0mmol\/mol) were included. The primary outcome was the incidence of T2DM. Pooled logistic regression was used to estimate adjusted risk ratios (RRs) and 5\u2010year cumulative incidence differences (CIDs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 5180 participants initiated tadalafil treatment and were compared with 20,049 patients who initiated alpha\u2010blockers. The median follow\u2010up time for each arm was 27.2 months (interquartile range [IQR], 12.0\u201347.9) in tadalafil users and 31.3 months (IQR, 13.7\u201357.2) in alpha\u2010blocker users. The incidence rates of T2DM in tadalafil and alpha\u2010blocker users were 5.4 (95% confidence interval [CI], 4.0\u20137.2) and 8.8 (95% CI, 7.8\u20139.8) per 1000\u2010person years, respectively. Initiation of tadalafil was associated with a reduced risk of T2DM (RR, 0.47; 95% CI, 0.39\u20130.62; 5\u2010year CID, \u22120.031; 95% CI, \u22120.040 to \u22120.019).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The incidence of T2DM was lower in men with BPH treated with tadalafil than in those treated with alpha\u2010blockers. Thus, tadalafil may be more beneficial than alpha\u2010blockers in preventing T2DM.<\/jats:p><\/jats:sec>","DOI":"10.1111\/joim.20012","type":"journal-article","created":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T17:23:51Z","timestamp":1726593831000},"page":"422-434","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Tadalafil use is associated with a lower incidence of Type 2 diabetes in men with benign prostatic hyperplasia: A population\u2010based cohort study"],"prefix":"10.1111","volume":"296","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0479-3733","authenticated-orcid":false,"given":"Atsushi","family":"Takayama","sequence":"first","affiliation":[{"name":"Department of Pharmacoepidemiology Kyoto University Graduate School of Medicine and Public Health  Kyoto 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