Cai Tong, Wang Ning, Liang Liye, Zhou Zhongbao, Zhang Yong, Cui Yuanshan
School of Clinical Medicine, Binzhou Medical University, Yantai, Shandong, China.
Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China.
Int Neurourol J. 2020 Dec;24(4):365-374. doi: 10.5213/inj.2040146.073. Epub 2020 Dec 31.
The aim of this meta-analysis was to evaluate the efficacy and safety of imidafenacin for overactive bladder (OAB) induced by benign prostatic hyperplasia (BPH) in men receiving alpha-blocker monotherapy.
We performed a systematic research of the PubMed, Embase, and Cochrane Library databases, and searched for studies about alpha-blocker with or without imidafenacin treatment for OAB in patients with BPH. We also investigated the original references of the included texts.
Four randomized controlled trials including 779 participants with BPH (389 in the alpha-blocker+imidafenacin group and 390 in the alpha-blocker only group) were studied. The main efficacy endpoint was the Overactive Bladder Symptom Score, which showed a mean difference of -1.88 (95% confidence interval, -2.32 to -1.44; P<0.00001), suggesting that alpha-blocker and imidafenacin treatment was effective in treating men with OAB. As other primary efficacy end points, the International Prostate Symptom Score (IPSS) total score (P=0.47), the IPSS storage symptom score (P=0.07), the IPSS voiding symptom score (P=0.60), and the IPSS quality of life score (P=0.18) indicated that 2 methods had no significant differences in treating men with OAB. In terms of safety, which was assessed using postvoid residual volume (P=0.05) and maximum flow rate (P=0.53), the analysis suggested that combination treatment was very well tolerated.
This study suggested that imidafenacin plus alpha-blocker was an efficacious and safe treatment for OAB symptoms in BPH patients.
本荟萃分析旨在评估在接受α受体阻滞剂单药治疗的男性中，咪达非那新治疗良性前列腺增生（BPH）所致膀胱过度活动症（OAB）的疗效和安全性。
我们对PubMed、Embase和Cochrane图书馆数据库进行了系统检索，查找关于α受体阻滞剂联合或不联合咪达非那新治疗BPH患者OAB的研究。我们还调查了纳入文献的原始参考文献。
对4项随机对照试验进行了研究，共纳入779例BPH患者（α受体阻滞剂+咪达非那新组389例，仅α受体阻滞剂组390例）。主要疗效终点为膀胱过度活动症症状评分，平均差值为-1.88（95%置信区间，-2.32至-1.44；P<0.00001），表明α受体阻滞剂联合咪达非那新治疗对OAB男性患者有效。作为其他主要疗效终点，国际前列腺症状评分（IPSS）总分（P=0.47）、IPSS储尿期症状评分（P=0.07）、IPSS排尿期症状评分（P=0.60）和IPSS生活质量评分（P=0.18）表明，两种方法在治疗OAB男性患者方面无显著差异。在安全性方面，通过残余尿量（P=0.05）和最大尿流率（P=0.53）进行评估，分析表明联合治疗耐受性良好。
本研究表明，咪达非那新联合α受体阻滞剂是治疗BPH患者OAB症状的一种有效且安全的方法。
