A Meta-Analysis on the Efficacy and Tolerability of &amp;alpha;&lt;sub&gt;1&lt;/sub&gt;-Adrenoceptor Antagonists in Patients with Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Obstruction

Djavan, Bob; Marberger, Michael

doi:10.1159/000019919

Cited by 367 publications

(239 citation statements)

References 60 publications

(26 reference statements)

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“…Other a 1 -AR antagonists appear to have similar efficacy in improving symptoms and urinary flow. 6 The total symptom score generally improves by 30-40% -which is consistent with the 37% improvement in total I-PSS found with tamsulosin in the present study -and Q max by 16-25% -for which an improvement of 31% is obtained in this study. Also, the results related to finasteride are consistent with the literature.…”

Section: Discussionsupporting

confidence: 91%

“…The incidence of discontinuations due to adverse events for tamsulosin over 52 weeks of treatment was 9.7%, which is similar to the rates reported in a meta-analysis of studies with a 1 -AR antagonists (4-10%) with, however, shorter treatment durations. 6 The withdrawal rate with finasteride was lower than that reported in the large trial mentioned before (6.4 vs 11%) with a treatment duration of only 6 months instead of 1 y in this study. 10 The urinary retention episodes, the incidence of which can be reduced with finasteride, as previously shown, 17 occurred in a comparable and low rate with finasteride and tamsulosin in the present study.…”

Section: Discussioncontrasting

confidence: 73%

“…This explains why these agents relieve symptoms effectively and very quickly (within weeks). Of the clinically available a 1 -AR antagonists, tamsulosin is the most frequently prescribed and it has a favourable efficacy/tolerability ratio, 6 which is maintained for up to 4 y (Europe) 7 and 6 y (US). 8 Although a 1 -AR antagonists have the highest market share among medical treatments for LUTS/BPH, finasteride is also prescribed in many patients, especially in Italy and the UK.…”

Section: Introductionmentioning

confidence: 99%

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A comparison of the efficacy and tolerability of tamsulosin and finasteride in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia

Rigatti

Brausi

Scarpa

et al. 2003

Prostate Cancer Prostatic Dis

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In this multicentre, double-blind study, patients with LUTS/BPH were randomised to 26 weeks with finasteride 5 mg once daily (n ¼ 204) or tamsulosin 0.4 mg once daily (n ¼ 199). Double-blind treatment was continued for another 26 weeks (total treatment duration: 1 y). The primary efficacy parameter was the difference in mean change in total Symptom Problem Index (SPI) from baseline to end point at week-26 in the intention-to-treat (ITT) and per protocol (PP) populations. Tamsulosin induced a greater improvement in total SPI (À5.2 points or À37%) compared to finasteride (À4.5 points or À31%) at week-26 (P ¼ 0.055 in ITT and P ¼ 0.032 in PP). Tamsulosin improved urinary symptoms (particularly the more bothersome storage symptoms) and flow more quickly than finasteride. The difference was statistically significant for the SPI from week-1 (reduction, respectively, À2.5 vs À1.8 points, P ¼ 0.043) to week-18 and for Q max from week-1 (increase, respectively, 2.3 vs 0.7 ml/s, P ¼ 0.0007) to week-12. Both treatments were well tolerated with a comparable incidence of adverse events, including urinary retention.

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Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

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A comparison of the efficacy and tolerability of tamsulosin and finasteride in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia

Rigatti

Brausi

Scarpa

et al. 2003

Prostate Cancer Prostatic Dis

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“…[1][2][3][4][5] Recent studies have highlighted the influence of a1-blockers on ejaculatory function. [6][7][8][9][10] A loss of seminal emission has been recently postulated as one of the mechanisms of abnormal ejaculation.…”

Section: Introductionmentioning

confidence: 99%

Orgasm is preserved regardless of ejaculatory dysfunction with selective α1A-blocker administration

et al. 2009

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We evaluated whether ejaculatory dysfunction induced with a selective a1A-blocker influenced orgasm. Fifteen healthy male volunteers took silodosin or a placebo in a randomized, double-blind crossover design. We investigated the ejaculatory volume before and after administration of the agents. After each ejaculation, participants self-reported the answers to an original questionnaire, which was about discomfort on ejaculation, orgasm and satisfaction with the discomforting ejaculation. All participants on silodosin had a complete lack of seminal emission and expulsion. All participants felt orgasm in spite of a complete lack of seminal emission. Of the 15, 12 (80%) who had a somewhat uncomfortable feeling during orgasm were dissatisfied with this feeling, although 9 of the 12 reported that its degree was mild. Orgasm is preserved regardless of the loss of seminal emission with silodosin administration. Although most participants reported mild discomfort during orgasm, they were greatly dissatisfied with the loss of seminal emission.

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“…11 Within the group of the a 1 -adrenoceptor antagonists (alfuzosin, doxazosin, prazosin, tamsulosin and terazosin), the prostate selective a 1 -adrenoceptor antagonist tamsulosin appears to have similar ef®cacy but to interfere less with blood pressure regulation than the other a 1 -adrenoceptor antagonists. 12 Unfortunately there is still very little information about men with LUTS seeking medical care in RLP and their subsequent management. In the French national community-based survey in 1992, mentioned above, the authors found that 8.3% of men had a diagnosis of LUTS of which 6.9% had undergone prostate surgery and 61% were treated medically.…”

Section: Introductionmentioning

confidence: 99%

Treatment of lower urinary tract symptoms suggestive of benign prostatic obstruction in real life practice in France

Vallancien

Pariente

2001

Prostate Cancer Prostatic Dis

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The objective of this work is to describe the pro®le of prevalent and incident populations suffering from lower urinary tract symptoms (LUTS) suggestive of benign prostatic obstruction (BPO) and to analyse the management of care by 620 general practitioners (GPs) in France in 1997 and 1998. Patient records were extracted from the THALES database. Special attention was given to the use of medical therapy and switch rates (ie change to another or combination with another drug). In real life practice (RLP) French GPs predominantly utilise a 1 -adrenoceptor antagonists for the treatment of LUTS. This is in agreement with available evidence from randomised controlled trials (RCTs) with different medical therapies (a 1 -adrenoceptor antagonists, ®nasteride, plant extracts). On the contrary, the relatively high usage of phytotherapy might be explained by traditional and personal preferences. Using purely descriptive statistics, newer a 1 -adrenoceptor antagonists, alfuzosin and tamsulosin, seem to be the most frequently prescribed medical therapy for new patients and are, moreover, associated with a low switch rate. Prostate Cancer and Prostatic Diseases (2001) 4, 124±131.

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A Meta-Analysis on the Efficacy and Tolerability of α<sub>1</sub>-Adrenoceptor Antagonists in Patients with Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Obstruction

Cited by 367 publications

References 60 publications

A comparison of the efficacy and tolerability of tamsulosin and finasteride in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia

A comparison of the efficacy and tolerability of tamsulosin and finasteride in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia

Orgasm is preserved regardless of ejaculatory dysfunction with selective α1A-blocker administration

Treatment of lower urinary tract symptoms suggestive of benign prostatic obstruction in real life practice in France

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