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Efficacy and Safety of Initial Combination Treatment of an Alpha Blocker with an Anticholinergic Medication in Benign Prostatic Hyperplasia Patients with Lower Urinary Tract Symptoms: Updated Meta-Analysis

原文:2017年 发布于 PLoS One 12卷 第1期 e0169248 浏览量:882次 原文链接

作者: Kim H. J. Sun H. Y. Choi H. Park J. Y. Bae J. H. Doo S. W. Yang W. J. Song Y. S. Ko Y. M. Kim J. H.

作者单位: Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea. Department of Urology, Soonchunhyang University Hospital, Sonchunhyang University College of Medicine, Seoul, Korea. Department of Urology, Korea University Hospital, Korea University College of Medicine, Ansan, Korea. Department of Industrial and Management Engineering, Pohang University of Science and Technology, Pohang, Korea.

归属分类: 良性前列腺增生治疗及预后证据

DOI: 10.1371/journal.pone.0169248

关键词: Adrenergic alpha-Antagonists/administration & dosage/*therapeutic use Cholinergic Antagonists/administration & dosage Drug Therapy Combination Humans *Lower Urinary Tract Symptoms Male Prostatic Hyperplasia/*diagnosis/*drug therapy Publication Bias Quality of Life Treatment Outcome

文献简介

BACKGROUND: There is still controversy as to whether initial combination treatment is superior to serial addition of anticholinergics after maintenance or induction of alpha blockers in benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS). OBJECTIVE: The objective of this study was to determine the benefits and safety of initial combination treatment of an alpha blocker with anticholinergic medication in BPH/LUTS through a systematic review and meta-analysis. METHODS: We conducted a meta-analysis of improvement in LUTS using International Prostate Symptom Score (IPSS), maximal urinary flow rate (Qmax), post-voided residual volume (PVR), and quality of life (QoL). RESULTS: In total, 16 studies were included in our analysis, with a total sample size of 3,548 subjects (2,195 experimental subjects and 1,353 controls). The mean change in total IPSS improvement from baseline in the combination group versus the alpha blocker monotherapy group was -0.03 (95% CI: -0.14-0.08). The pooled overall SMD change of storage IPSS improvement from baseline was -0.28 (95% CI: -0.40 - -0.17). The pooled overall SMD changes of QoL, Qmax, and PVR were -0.29 (95% CI: -0.50 - -0.07), 0.00 (95% CI: -0.08-0.08), and 0.56 (95% CI: 0.23-0.89), respectively. There was no significant difference in the number of acute urinary retention (AUR) events or PVR. CONCLUSIONS: Initial combination treatment of an alpha blocker with anticholinergic medication is efficacious for in BPH/ LUTS with improved measures such as storage symptoms and QoL without causing significant deterioration of voiding function.

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