Silodosin is effective for treatment of LUTS in men with BPH: a systematic review

Abstract

The aim of this study was to systematically review the evidence on the efficacy and safety of silodosin treatments on lower urinary tract symptoms (LUTS) in men with benign prostatic hyperplasia (BPH) from randomized controlled trials. We searched PubMed (1966-December 2011), Embase (1974-December 2011 and the Cochrane Library Database (2011, Issue 12). The assessed outcome measures were the change from baseline for the International Prostate Symptom Score (IPSS), quality of life (QoL) score, peak urine maximum flow rate (Q max ), QoL related to urinary symptoms and adverse effects. Two authors independently assessed the study quality and extracted data. All data were analysed using RevMan 5.1. The meta-analysis included four randomized controlled trials with a total of 2504 patients. The study durations were each 12 weeks. At the follow-up end points, the pooled results showed that the change from baseline for the silodosin group was significantly higher than the placebo group for the IPSS, QoL score and Q max (mean difference (MD)522.78, P,0.00001; MD520.42, P50.004; MD51.17, P,0.00001,respectively) and patients felt more satisfied with QoL related to urinary symptoms in the silodosin group than the placebo group. Ejaculation disorder was the most commonly reported adverse effect. The pooled results also showed that the silodosin group was superior to the 0.2 mg tamsulosin group with respect to the IPSS and QoL score (IPSS: MD521.14, P50.02; QoL score: MD520.26, P50.02) and inferior to the 0.2 mg tamsulosin group with respect to Q max (MD520.85, P50.01). In contrast, there was no significant difference in the incidence of ejaculation disorder and dizziness between the silodosin and 0.2 mg tamsulosin groups. The current meta-analysis suggested that silodosin is an effective therapy for LUTS in men with BPH and is not inferior to 0.2 mg tamsulosin. Keywords: benign prostatic hyperplasia (BPH); KMD-3213; lower urinary tract symptoms (LUTS); silodosin; tamsulosin; systematic review; meta-analysis INTRODUCTION Histologically, benign prostatic hyperplasia (BPH) is a non-malignant enlargement of the prostate caused by cellular hyperplasia of both glandular and stromal elements.1 However, it is clinically characterised by lower urinary tract symptoms (LUTS) (urinary frequency, urgency, a weak and intermittent stream, the need to strain, a sense of incomplete emptying and nocturia), and can lead to complications, including acute urinary retention.2 The development of human BPH correlates with increasing age, 3 and LUTS are fairly common after the age of 50 years. 4 As is well known, the treatment options include alpha-blockers, five alpha-reductase inhibitors, transurethral resection of the prostate, transurethral microwave thermotherapy and herbal treatments (saw palmetto and b-sitosterol plant extracts). According to the EAU 2011 guidelines, alpha-blockers are currently the preferred first-line therapy for all men with moderate or severe LUTS/BPH.5 Alpha-blockers for BPH include alfuzosin, prazosin, doxazosin, tamsul...

The role of Silodosin as a new medical expulsive therapy for ureteral stones: a meta-analysis

“…23 The previous meta-analysis showed that Silodosin is an effective therapy for lower urinary tract symptoms in men with BPH and is not inferior to 0.2 mg tamsulosin. 24 It is reported that ureteral contraction was regulated mainly by alpha-1A adrenoceptors in the hamster ureter. 25 Furthermore, Silodosin was demonstrated to have a higher selectivity for the alpha1A-AR subtype than tamsulosin hydrochloride, naftopidil, or prazosin hydrochloride, and the alpha1A-to-alpha1D binding ratio of Silodosin is 56:1.…”

A Comparative Study of Silodosin and Tamsulosin in Treatment of Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia

“…Ding et al 16 in a recent systematic review have also suggested that silodosin is effective therapy for LUTS in men with BPH and is not inferior to 0.2 mg tamsulosin.…”

α‐Adrenergic Antagonists for Lower Urinary Symptoms Secondary to Benign Prostatic Hyperplasia

“…In a metaanalysis, Ding et al reported consistently higher rates of ejaculatory dysfunction with silodosin compared with tamsulosin [63]. In a metaanalysis, Ding et al reported consistently higher rates of ejaculatory dysfunction with silodosin compared with tamsulosin [63].…”