Cargando…

Defining the Efficacy and Safety of Phosphodiesterase Type 5 Inhibitors with Tamsulosin for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia with or without Erectile Dysfunction: A Network Meta-Analysis

PURPOSE: The purpose of this study was to compare the relative safety and efficacy of different types of phosphodiesterase type 5 inhibitors (PDE5-Is) with tamsulosin for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostate hyperplasia (BPH) (BPH-LUTS) with or without er...

Descripción completa

Detalles Bibliográficos
Autores principales: Ma, Chengquan, Zhang, Jianzhong, Cai, Zhonglin, Xiong, Jian, Li, Hongjun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7140123/
https://www.ncbi.nlm.nih.gov/pubmed/32309423
http://dx.doi.org/10.1155/2020/1419520
_version_ 1783518924772474880
author Ma, Chengquan
Zhang, Jianzhong
Cai, Zhonglin
Xiong, Jian
Li, Hongjun
author_facet Ma, Chengquan
Zhang, Jianzhong
Cai, Zhonglin
Xiong, Jian
Li, Hongjun
author_sort Ma, Chengquan
collection PubMed
description PURPOSE: The purpose of this study was to compare the relative safety and efficacy of different types of phosphodiesterase type 5 inhibitors (PDE5-Is) with tamsulosin for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostate hyperplasia (BPH) (BPH-LUTS) with or without erectile dysfunction (ED). METHODS: We use the Stata version 13.0 to conduct the network meta-analysis (NMA) with a random effects model of the Bayesian framework. The International Prostate Symptom Score (IPSS), Maximum Urinary Flow Fate (Q(max)), International Index of Erectile Function (IIEF), and their credible intervals (CI) were used to compare the efficacy and safety of every medical intervention, including sildenafil plus tamsulosin, tadalafil plus tamsulosin, and vardenafil plus tamsulosin. RESULTS: Seven RCTs including 531 participants with seven interventions were analyzed. The results of NMA SUCRA showed that compared with different doses or types of PDE5-Is combined with tamsulosin (0.4 mg qd), the sildenafil (25 mg qd) combined with tamsulosin (0.4 mg qd) group had the greatest probabilities of being the best in the achievement of improving IIEF. The sildenafil (25 mg 4 days per week) combined with tamsulosin (0.4 mg qd) group had the greatest probabilities of being the best in the achievement of improving Q(max), whereas sildenafil (25 mg qd) combined with tamsulosin (0.4 mg qd) ranked the best for the safety outcomes. CONCLUSIONS: This meta-analysis indicates that sildenafil combined with tamsulosin is the best effective and tolerated treatment option for BPH-LUTS with or without ED. Further RCTs are strongly required to provide more direct evidence.
format Online
Article
Text
id pubmed-7140123
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Hindawi
record_format MEDLINE/PubMed
spelling pubmed-71401232020-04-18 Defining the Efficacy and Safety of Phosphodiesterase Type 5 Inhibitors with Tamsulosin for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia with or without Erectile Dysfunction: A Network Meta-Analysis Ma, Chengquan Zhang, Jianzhong Cai, Zhonglin Xiong, Jian Li, Hongjun Biomed Res Int Review Article PURPOSE: The purpose of this study was to compare the relative safety and efficacy of different types of phosphodiesterase type 5 inhibitors (PDE5-Is) with tamsulosin for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostate hyperplasia (BPH) (BPH-LUTS) with or without erectile dysfunction (ED). METHODS: We use the Stata version 13.0 to conduct the network meta-analysis (NMA) with a random effects model of the Bayesian framework. The International Prostate Symptom Score (IPSS), Maximum Urinary Flow Fate (Q(max)), International Index of Erectile Function (IIEF), and their credible intervals (CI) were used to compare the efficacy and safety of every medical intervention, including sildenafil plus tamsulosin, tadalafil plus tamsulosin, and vardenafil plus tamsulosin. RESULTS: Seven RCTs including 531 participants with seven interventions were analyzed. The results of NMA SUCRA showed that compared with different doses or types of PDE5-Is combined with tamsulosin (0.4 mg qd), the sildenafil (25 mg qd) combined with tamsulosin (0.4 mg qd) group had the greatest probabilities of being the best in the achievement of improving IIEF. The sildenafil (25 mg 4 days per week) combined with tamsulosin (0.4 mg qd) group had the greatest probabilities of being the best in the achievement of improving Q(max), whereas sildenafil (25 mg qd) combined with tamsulosin (0.4 mg qd) ranked the best for the safety outcomes. CONCLUSIONS: This meta-analysis indicates that sildenafil combined with tamsulosin is the best effective and tolerated treatment option for BPH-LUTS with or without ED. Further RCTs are strongly required to provide more direct evidence. Hindawi 2020-03-26 /pmc/articles/PMC7140123/ /pubmed/32309423 http://dx.doi.org/10.1155/2020/1419520 Text en Copyright © 2020 Chengquan Ma et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Ma, Chengquan
Zhang, Jianzhong
Cai, Zhonglin
Xiong, Jian
Li, Hongjun
Defining the Efficacy and Safety of Phosphodiesterase Type 5 Inhibitors with Tamsulosin for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia with or without Erectile Dysfunction: A Network Meta-Analysis
title Defining the Efficacy and Safety of Phosphodiesterase Type 5 Inhibitors with Tamsulosin for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia with or without Erectile Dysfunction: A Network Meta-Analysis
title_full Defining the Efficacy and Safety of Phosphodiesterase Type 5 Inhibitors with Tamsulosin for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia with or without Erectile Dysfunction: A Network Meta-Analysis
title_fullStr Defining the Efficacy and Safety of Phosphodiesterase Type 5 Inhibitors with Tamsulosin for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia with or without Erectile Dysfunction: A Network Meta-Analysis
title_full_unstemmed Defining the Efficacy and Safety of Phosphodiesterase Type 5 Inhibitors with Tamsulosin for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia with or without Erectile Dysfunction: A Network Meta-Analysis
title_short Defining the Efficacy and Safety of Phosphodiesterase Type 5 Inhibitors with Tamsulosin for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia with or without Erectile Dysfunction: A Network Meta-Analysis
title_sort defining the efficacy and safety of phosphodiesterase type 5 inhibitors with tamsulosin for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia with or without erectile dysfunction: a network meta-analysis
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7140123/
https://www.ncbi.nlm.nih.gov/pubmed/32309423
http://dx.doi.org/10.1155/2020/1419520
work_keys_str_mv AT machengquan definingtheefficacyandsafetyofphosphodiesterasetype5inhibitorswithtamsulosinforthetreatmentoflowerurinarytractsymptomssecondarytobenignprostatichyperplasiawithorwithouterectiledysfunctionanetworkmetaanalysis
AT zhangjianzhong definingtheefficacyandsafetyofphosphodiesterasetype5inhibitorswithtamsulosinforthetreatmentoflowerurinarytractsymptomssecondarytobenignprostatichyperplasiawithorwithouterectiledysfunctionanetworkmetaanalysis
AT caizhonglin definingtheefficacyandsafetyofphosphodiesterasetype5inhibitorswithtamsulosinforthetreatmentoflowerurinarytractsymptomssecondarytobenignprostatichyperplasiawithorwithouterectiledysfunctionanetworkmetaanalysis
AT xiongjian definingtheefficacyandsafetyofphosphodiesterasetype5inhibitorswithtamsulosinforthetreatmentoflowerurinarytractsymptomssecondarytobenignprostatichyperplasiawithorwithouterectiledysfunctionanetworkmetaanalysis
AT lihongjun definingtheefficacyandsafetyofphosphodiesterasetype5inhibitorswithtamsulosinforthetreatmentoflowerurinarytractsymptomssecondarytobenignprostatichyperplasiawithorwithouterectiledysfunctionanetworkmetaanalysis