General effect of low-dose tamsulosin (0.2 mg) as a first-line treatment for lower urinary tract symptoms associated with benign prostatic hyperplasia: a systematic review and meta-analysis

Abstract

Although this study did not consider placebo effect and has high IPSS baseline scores, this study clarifies that low-dose tamsulosin has generally positive effect and safety in treatment of LUTS and could be a suitable option as an initial treatment, especially for patients with low body mass index, as is typical of Asian people.

Evidence Is Enough?: A Systematic Review and Network Meta-Analysis of the Efficacy of Tamsulosin 0.2 mg and Tamsulosin 0.4 mg as an Initial Therapeutic Dose in Asian Benign Prostatic Hyperplasia Patients

“…This result is different from those of the above researchers who investigated tamsulosin in Asian men with BPH and used Tam 0.2 as the standard dose for initial treatment [1-4]. Therefore, a reassessment of the efficacy and safety of tamsulosin in Asian men with BPH is necessary to clarify this discrepancy between the recent study [5] and the general consensus [1-4]. However, direct comparison studies to compare the efficacy and safety between Tam 0.2 and Tam 0.4 as the initial treatment dose in Asian men with BPH are insufficient.…”

“…The investigators noted that Korean men with BPH receiving Tam 0.4 showed significant improvements on the International Prostatic Symptom Score (IPSS) compared with men receiving Tam 0.2 as their initial treatment dose after 12 weeks of medication. This result is different from those of the above researchers who investigated tamsulosin in Asian men with BPH and used Tam 0.2 as the standard dose for initial treatment [1-4]. Therefore, a reassessment of the efficacy and safety of tamsulosin in Asian men with BPH is necessary to clarify this discrepancy between the recent study [5] and the general consensus [1-4].…”

“…(3) Randomization, blind method, and intention-to-treat (ITT) analysis were performed in RCTs. Only one article using direct treatment comparison (DTC) between Tam 0.2 and Tam 0.4 [4] did not meet selection criteria. However, we input this article to estimate for mixed treatment comparison (MTC) analysis.…”

“…The difference of initially recommended doses between Asian and Western men with BPH was based on clinical trials meant to evaluate efficacy and adverse effect; therefore, the initial treatment dose was decided as 0.2 mg for Asian men and 0.4 mg for Western men [2]. In Korea as well as in other Asian countries, men experiencing LUTS due to BPH have an improvement of symptoms and effects after initial treatment with Tam 0.2 mg compared with men treated with other types of alpha-blockers [3,4]. Therefore, the general consensus of a standard initial dose of Tam 0.2 in Asian men is a reasonable estimate for the treatment of LUTS due to BPH.…”

Broaden and Build Up Knowledge Based on Investigative and Clinical Research

“…Therefore, the initial standard dose of tamsulosin was introduced to patients with BPH was 0.2 mg for Asian men and 0.4 mg for Western men [9,10]. The degrees of improvements in international prostate symptom score and maximal flow rate were similar between Asian patients with BPH treated with tamsulosin 0.2 mg and Western patients with BPH treatmed with tamsulosin 0.4 mg [11,12]. In addition, no significant adverse events were found in the patients in both groups.…”