Tamsulosin combined with solifenacin versus tamsulosin monotherapy for male lower urinary tract symptoms: a meta-analysis

Gong, Mancheng; Dong, Wenjing; Huang, Guiying; Gong, Zhaoyang; Deng, Decheng; Qiu, Shaofu; Yuan, Runqiang

doi:10.1185/03007995.2015.1074067

Cited by 24 publications

(16 citation statements)

References 38 publications

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“…The treatment response for male LUTS patients have been affected by differences in α1‐adrenergic receptors subtype selectivity against various types of alpha‐blockers; however, we were primarily concerned with evaluating the additional benefits of addition of anticholinergic. Similar results have been reported from studies that have investigated the effectiveness and safety of combination therapy comprising imidafenacin and tamsulocin . Second, the present study did not separate the patients according to the severity of the bladder outlet obstruction.…”

Section: Discussionsupporting

confidence: 84%

“…Similar results have been reported from studies that have investigated the effectiveness and safety of combination therapy comprising imidafenacin and tamsulocin. 29,30 Second, the present study did not separate the patients according to the severity of the bladder outlet obstruction. If anticholinergic agents are prescribed to male patients with LUTS that are associated with BPH, different results should be expected depending on the grade of the bladder outlet obstruction.…”

Section: Discussionmentioning

confidence: 90%

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A multicenter real-life study of the efficacy of an alpha-blocker with or without anticholinergic agent (imidafenacin) treatment in patients with lower urinary tract symptoms/benign prostatic hyperplasia and storage symptoms

et al. 2017

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 90%

A multicenter real-life study of the efficacy of an alpha-blocker with or without anticholinergic agent (imidafenacin) treatment in patients with lower urinary tract symptoms/benign prostatic hyperplasia and storage symptoms

et al. 2017

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“…Although combination therapy with an alpha‐blocker and anticholinergic markedly improved the storage symptoms compared with alpha‐blocker monotherapy, there were significant increases in the incidence of voiding difficulties and in RU volume with combination therapy; furthermore, voiding‐related adverse events, such as urinary retention, are commonly reported . Even in the present study, treatment was discontinued in approximately 16% of patients in the solifenacin group due to voiding difficulty and urinary retention.…”

Section: Discussioncontrasting

confidence: 53%

Effect of tadalafil add‐on therapy in patients with persistant storage symptoms refractory to α₁‐adrenoceptor antagonist monotherapy for benign prostatic hyperplasia: A randomized pilot trial comparing tadalafil and solifenacin

Urakami

Ogawa

Oka

et al. 2018

LUTS

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Objective: The aim of this study was to investigate the efficacy and safety of tadalafil add-on therapy with α 1 -adrenoceptor antagonists.Methods: Patients with persistent storage symptoms refractory to α 1 -adrenoceptor antagonists for benign prostatic hyperplasia were enrolled in the study. Patients were randomly assigned to either a 5 mg tadalafil or 5 mg solifenacin treatment group for 12 weeks. International Prostate Symptom Score, Overactive Bladder Symptom Score, urinary flow rates, residual urine volume, and blood pressure were measured prospectively before treatment and after 4 and 12 weeks of treatment. Changes from baseline were compared between groups. The rate of treatment discontinuation due to adverse effects was evaluated.Results: Of the 75 patients recruited to the study, 38 and 37 were assigned to the tadalafil and solifenacin groups, respectively. There were no significant difference in baseline characteristics between the two groups. The change in the amount of residual urine volume was significantly larger in the solifenacin-than tadalafil-treated group; other parameters, including lower urinary tract symptoms and uroflowmetry measures, did not differ significantly between the two groups. Seven (18%) and 12 (32%) patients in the tadalafil and solifenacin groups, respectively, discontinued treatment because of adverse events. The main reasons for discontinuation in the tadalafil group were stomach discomfort or nausea and dizziness or vertigo; voiding difficulty and constipation were the main reasons for discontinuation in the solifenacin group. There was no significant difference in blood pressure fluctuations from baseline between the two groups.Conclusions: Tadalafil add-on therapy was not inferior to solifenacin add-on therapy in terms of effect and safety. Therefore, tadalafil could be an alternative add-on drug for patients with persistent lower urinary tract symptoms refractory to α 1 -adrenoceptor antagonists. K E Y W O R D S α 1 -adrenoceptor antagonist, benign prostatic hyperplasia, lower urinary tract symptoms, overactive bladder, solifenacin succinate, tadalafil 1 | INTRODUCTION Benign prostatic hyperplasia (BPH) is a representative underlying disease that triggers lower urinary tract symptoms (LUTS). Aging-related prostate enlargement triggers mechanical prostatic urethral obstruction, increases the density of α 1 -adrenoceptors in the bladder neck and prostatic urethra, and decreases nitric oxide (NO) secretion. 1 These result in smooth muscle hypertonia of the lower urinary tract, causing functional obstruction. In addition, most cases of BPH involve LUTS, such as voiding difficulties and storage symptoms due to an

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“…Combined therapy of α1‐blockers and anticholinergics is recommended for OAB symptoms associated with BPH (level 1; grade A) . Combined therapy of α1‐blockers and β3‐agonists might be beneficial (level 3; grade C1) .…”

Section: Clinical Questionsmentioning

confidence: 99%

“…For men with BOO, the efficacy is limited (level 1; grade C1), and the safety concern, such as voiding difficulty, is not resolved . α1‐Blockers should be first administered to OAB with BPH, and anticholinergics are to be combined when α1‐blocker monotherapy is insufficient (level 1) …”

Section: Treatmentmentioning

confidence: 99%

Clinical guidelines for male lower urinary tract symptoms and benign prostatic hyperplasia

et al. 2017

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The present article is the abbreviated English translation of the Japanese guidelines for male lower urinary tract symptoms and benign prostatic hyperplasia updated as of the end of 2016. The target patients are men aged >50 years complaining of lower urinary tract symptoms, with or without benign prostatic hyperplasia, and the target readers are non-urological general physicians and urologists. Mandatory assessment for general physicians is medical history, physical examination, urinalysis and measurement of serum prostate-specific antigen. Additional mandatory assessment for urologists is symptoms and quality of life assessment by questionnaires, uroflowmetry, residual urine measurement, and prostate ultrasonography. Nocturia requires special attention, as it can result from nocturnal polyuria and/or sleep disturbance rather than lower urinary tract disorders. Functional lower urinary tract disorders with or without benign prostatic hyperplasia are primarily managed by conservative therapy and medications, such as a 1 -blockers and phosphodiesterase-type 5 inhibitors. Use of other medications or combination pharmacotherapy is to be reserved for urologists. 5a-Reductase inhibitors and anticholinergics or b3 agonists are indicated for men with enlarged prostates and overactive bladder symptoms, respectively. Surgical intervention for bladder outlet obstruction is considered for persistent symptoms or benign prostatic hyperplasia-related comorbidities. Surgical modalities should be optimized by the patient's characteristics, performance of equipment and the surgeon's experience.

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Tamsulosin combined with solifenacin versus tamsulosin monotherapy for male lower urinary tract symptoms: a meta-analysis

Abstract: Tamsulosin and solifenacin combination therapy may be a reasonable option for male LUTS patients, especially for those who have significant storage symptoms. However, PVR should be measured during treatment to assess the increase in PVR or the incidence of AUR.

Cited by 24 publications

References 38 publications

A multicenter real-life study of the efficacy of an alpha-blocker with or without anticholinergic agent (imidafenacin) treatment in patients with lower urinary tract symptoms/benign prostatic hyperplasia and storage symptoms

A multicenter real-life study of the efficacy of an alpha-blocker with or without anticholinergic agent (imidafenacin) treatment in patients with lower urinary tract symptoms/benign prostatic hyperplasia and storage symptoms

Effect of tadalafil add‐on therapy in patients with persistant storage symptoms refractory to α₁‐adrenoceptor antagonist monotherapy for benign prostatic hyperplasia: A randomized pilot trial comparing tadalafil and solifenacin

Clinical guidelines for male lower urinary tract symptoms and benign prostatic hyperplasia

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Tamsulosin combined with solifenacin versus tamsulosin monotherapy for male lower urinary tract symptoms: a meta-analysis

Abstract: Tamsulosin and solifenacin combination therapy may be a reasonable option for male LUTS patients, especially for those who have significant storage symptoms. However, PVR should be measured during treatment to assess the increase in PVR or the incidence of AUR.

Cited by 24 publications

References 38 publications

A multicenter real-life study of the efficacy of an alpha-blocker with or without anticholinergic agent (imidafenacin) treatment in patients with lower urinary tract symptoms/benign prostatic hyperplasia and storage symptoms

A multicenter real-life study of the efficacy of an alpha-blocker with or without anticholinergic agent (imidafenacin) treatment in patients with lower urinary tract symptoms/benign prostatic hyperplasia and storage symptoms

Effect of tadalafil add‐on therapy in patients with persistant storage symptoms refractory to α1‐adrenoceptor antagonist monotherapy for benign prostatic hyperplasia: A randomized pilot trial comparing tadalafil and solifenacin

Clinical guidelines for male lower urinary tract symptoms and benign prostatic hyperplasia

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Effect of tadalafil add‐on therapy in patients with persistant storage symptoms refractory to α₁‐adrenoceptor antagonist monotherapy for benign prostatic hyperplasia: A randomized pilot trial comparing tadalafil and solifenacin