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5型磷酸二酯酶抑制剂对良性前列腺增生继发下尿路症状的影响

[Effects of phosphodiesterase type 5 inhibitors on lower urinary tract symptoms secondary to benign prostatic hyperplasia].

作者信息

Giuliano F, Rouprêt M, Doridot G, de la Taille A

机构信息

Neuro-uro-andrologie, service de médecine physique et de réadaptation, hôpital Raymond-Poincaré, faculté des sciences de la santé, université de Versailles Saint-Quentin-en-Yvelines, 92380 Garches, France.

出版信息

Prog Urol. 2013 Apr;23(5):283-95. doi: 10.1016/j.purol.2012.11.009. Epub 2012 Dec 28.

Abstract

PURPOSE

The objective of this literature review was to report currently available clinical data on the effects of phosphodiesterase type 5 inhibitors (PDE5I) on lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH).

METHODS

An international literature review was carried out in February 2012 from the Medline database (National Library of Medicine, United States). Studies on the effects of PDE5I on LUTS secondary to BPH published within the last 15 years (1997 to 2012) were extracted. In total, 12 studies were selected: four studies on sildenafil including one randomized, controlled, double-blind study; one randomized, controlled, double-blind study on vardenafil; and seven studies on tadalafil including five randomized, controlled, double-blind studies and a 1-year open-label extension study.

RESULTS

PDE5Is significantly improve the overall international prostatic symptom score (IPSS) compared to placebo. Most often, the maximum urinary flow rate (Qmax) was not significantly increased versus placebo. A statistically significant improvement of Qmax was nevertheless observed in certain studies.

CONCLUSION

The available clinical data assessing the efficacy of PDE5 inhibition in LUTS secondary to BPH are convincing. PDE5Is thus are a new therapeutic class in the treatment of this disease and are especially interesting in patients suffering from both LUTS and erectile dysfunction (ED), two frequently associated diseases.

摘要

目的

本综述的目的是报告目前关于5型磷酸二酯酶抑制剂(PDE5I)对良性前列腺增生(BPH)继发的下尿路症状(LUTS)影响的临床数据。

方法

2012年2月对美国国立医学图书馆的Medline数据库进行了一项国际文献综述。提取了过去15年(1997年至2012年)发表的关于PDE5I对BPH继发的LUTS影响的研究。总共选择了12项研究:四项关于西地那非的研究,包括一项随机对照双盲研究;一项关于伐地那非的随机对照双盲研究;以及七项关于他达拉非的研究,包括五项随机对照双盲研究和一项为期1年的开放标签扩展研究。

结果

与安慰剂相比,PDE5I能显著改善国际前列腺症状总分(IPSS)。大多数情况下,最大尿流率(Qmax)与安慰剂相比没有显著增加。然而,在某些研究中观察到Qmax有统计学意义的改善。

结论

评估PDE5抑制对BPH继发的LUTS疗效的现有临床数据令人信服。因此,PDE5I是治疗该疾病的一类新的治疗药物,对于同时患有LUTS和勃起功能障碍(ED)这两种常见相关疾病的患者尤其有意义。

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