Cargando…

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

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Kim, Hyun Jung, Sun, Hwa Yeon, Choi, Hoon, Park, Jae Young, Bae, Jae Hyun, Doo, Seung Whan, Yang, Won Jae, Song, Yun Seob, Ko, Young Myoung, Kim, Jae Heon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5224810/
https://www.ncbi.nlm.nih.gov/pubmed/28072862
http://dx.doi.org/10.1371/journal.pone.0169248
_version_ 1782493423979200512
author Kim, Hyun Jung
Sun, Hwa Yeon
Choi, Hoon
Park, Jae Young
Bae, Jae Hyun
Doo, Seung Whan
Yang, Won Jae
Song, Yun Seob
Ko, Young Myoung
Kim, Jae Heon
author_facet Kim, Hyun Jung
Sun, Hwa Yeon
Choi, Hoon
Park, Jae Young
Bae, Jae Hyun
Doo, Seung Whan
Yang, Won Jae
Song, Yun Seob
Ko, Young Myoung
Kim, Jae Heon
author_sort Kim, Hyun Jung
collection PubMed
description 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.
format Online
Article
Text
id pubmed-5224810
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-52248102017-01-31 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 Kim, Hyun Jung Sun, Hwa Yeon Choi, Hoon Park, Jae Young Bae, Jae Hyun Doo, Seung Whan Yang, Won Jae Song, Yun Seob Ko, Young Myoung Kim, Jae Heon PLoS One Research Article 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. Public Library of Science 2017-01-10 /pmc/articles/PMC5224810/ /pubmed/28072862 http://dx.doi.org/10.1371/journal.pone.0169248 Text en © 2017 Kim et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Kim, Hyun Jung
Sun, Hwa Yeon
Choi, Hoon
Park, Jae Young
Bae, Jae Hyun
Doo, Seung Whan
Yang, Won Jae
Song, Yun Seob
Ko, Young Myoung
Kim, Jae Heon
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5224810/
https://www.ncbi.nlm.nih.gov/pubmed/28072862
http://dx.doi.org/10.1371/journal.pone.0169248
work_keys_str_mv AT kimhyunjung efficacyandsafetyofinitialcombinationtreatmentofanalphablockerwithananticholinergicmedicationinbenignprostatichyperplasiapatientswithlowerurinarytractsymptomsupdatedmetaanalysis
AT sunhwayeon efficacyandsafetyofinitialcombinationtreatmentofanalphablockerwithananticholinergicmedicationinbenignprostatichyperplasiapatientswithlowerurinarytractsymptomsupdatedmetaanalysis
AT choihoon efficacyandsafetyofinitialcombinationtreatmentofanalphablockerwithananticholinergicmedicationinbenignprostatichyperplasiapatientswithlowerurinarytractsymptomsupdatedmetaanalysis
AT parkjaeyoung efficacyandsafetyofinitialcombinationtreatmentofanalphablockerwithananticholinergicmedicationinbenignprostatichyperplasiapatientswithlowerurinarytractsymptomsupdatedmetaanalysis
AT baejaehyun efficacyandsafetyofinitialcombinationtreatmentofanalphablockerwithananticholinergicmedicationinbenignprostatichyperplasiapatientswithlowerurinarytractsymptomsupdatedmetaanalysis
AT dooseungwhan efficacyandsafetyofinitialcombinationtreatmentofanalphablockerwithananticholinergicmedicationinbenignprostatichyperplasiapatientswithlowerurinarytractsymptomsupdatedmetaanalysis
AT yangwonjae efficacyandsafetyofinitialcombinationtreatmentofanalphablockerwithananticholinergicmedicationinbenignprostatichyperplasiapatientswithlowerurinarytractsymptomsupdatedmetaanalysis
AT songyunseob efficacyandsafetyofinitialcombinationtreatmentofanalphablockerwithananticholinergicmedicationinbenignprostatichyperplasiapatientswithlowerurinarytractsymptomsupdatedmetaanalysis
AT koyoungmyoung efficacyandsafetyofinitialcombinationtreatmentofanalphablockerwithananticholinergicmedicationinbenignprostatichyperplasiapatientswithlowerurinarytractsymptomsupdatedmetaanalysis
AT kimjaeheon efficacyandsafetyofinitialcombinationtreatmentofanalphablockerwithananticholinergicmedicationinbenignprostatichyperplasiapatientswithlowerurinarytractsymptomsupdatedmetaanalysis