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坦索罗辛联合他达拉非与坦索罗辛单药治疗良性前列腺增生症下尿路症状男性患者的疗效和安全性的系统评价和荟萃分析。

A Systematic Review and Meta-Analysis of the Efficacy and Safety of Tamsulosin Plus Tadalafil Compared With Tamsulosin Alone in Treating Males With Lower Urinary Tract Symptoms Secondary to Benign Prostrate Hyperplasia.

机构信息

Department of Urology, Sichuan Science City Hospital, MianYang, China.

Department of Urology, Beijing TianTan Hospital, Capital Medical University, Beijing, China.

出版信息

Am J Mens Health. 2023 Jan-Feb;17(1):15579883231155096. doi: 10.1177/15579883231155096.

DOI:10.1177/15579883231155096
PMID:36842963
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9972064/
Abstract

Lower urinary tract symptoms (LUTS) secondary to benign prostrate hyperplasia (BPH) are common geriatric diseases, and its incidence rises with age. The treatment of BPH and LUTS is becoming a burden for health care. The meta-analysis was performed to evaluate the efficacy and safety of combination therapy (tamsulosin plus tadalafil) compared with tamsulosin alone in treatment of males with LUTS/BPH. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses were utilized to conduct this study. There were several databases available for literature retrieval, including Medline, Embase, PubMed, Scopus, Web of Science databases, and Cochrane Controlled Trials Register. To improve the comprehensiveness of the search, related references were also searched. Finally, six randomized controlled trials including 441 patients were included. The combination therapy had significant improvements in total International Prostate Symptom Score ( < .0001), quality of life score ( = .003), maximum urine flow rate ( < .00001), and International Index of Erectile Function ( < .00001) compared with the tamsulosin monotherapy, but there was no obvious difference in postvoid residual volume ( = .06). In terms of safety, the combination group had comparable rates of discontinuation due to adverse events ( = .19) than the monotherapy group except for pain symptoms ( < .0001). The combination of tamsulosin and tadalafil provided a preferable therapeutic effect compared with the tamsulosin alone in treating males with BPH/LUTS, and both therapy regimens were well tolerated by the patients.

摘要

下尿路症状(LUTS)继发于良性前列腺增生(BPH)是常见的老年疾病,其发病率随着年龄的增长而上升。BPH 和 LUTS 的治疗正在成为医疗保健的负担。进行了荟萃分析,以评估联合治疗(坦索罗辛加他达拉非)与坦索罗辛单药治疗 LUTS/BPH 男性的疗效和安全性。本研究采用系统评价和荟萃分析的首选报告项目进行。有几个数据库可用于文献检索,包括 Medline、Embase、PubMed、Scopus、Web of Science 数据库和 Cochrane 对照试验登记处。为了提高搜索的全面性,还搜索了相关参考文献。最终纳入了 6 项随机对照试验,共 441 例患者。与坦索罗辛单药治疗相比,联合治疗在总国际前列腺症状评分(<0.0001)、生活质量评分(=0.003)、最大尿流率(<0.00001)和国际勃起功能指数(<0.00001)方面均有显著改善,但在剩余尿量方面无明显差异(=0.06)。在安全性方面,联合组因不良反应停药率与单药组相当(=0.19),除疼痛症状外(<0.0001)。坦索罗辛和他达拉非联合治疗与坦索罗辛单药治疗相比,为 BPH/LUTS 男性提供了更好的治疗效果,两种治疗方案均能被患者很好地耐受。

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本文引用的文献

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Tamsulosin and placebo vs tamsulosin and tadalafil in male lower urinary tract symptoms: a double-blinded, randomised controlled trial.坦索罗辛和安慰剂与坦索罗辛和他达拉非治疗男性下尿路症状的比较:一项双盲、随机对照试验。
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Meta-Analysis of Efficacy and Safety of Tadalafil Plus Tamsulosin Compared with Tadalafil Alone in Treating Men with Benign Prostatic Hyperplasia and Erectile Dysfunction.
良性前列腺梗阻的治疗算法:当前技术概述
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Add-on effects of tadalafil in tamsulosin-treated patients with small benign prostatic enlargement: A randomized, placebo-controlled, double-blind, crossover study.坦索罗辛治疗小体积良性前列腺增生患者的附加效应:一项随机、安慰剂对照、双盲、交叉研究。
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Sex Med. 2019 Sep;7(3):282-291. doi: 10.1016/j.esxm.2019.06.006. Epub 2019 Jul 12.
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Study of phosphodiesterase 5 inhibitors and α-adrenoceptor antagonists used alone or in combination for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia.磷酸二酯酶5抑制剂和α-肾上腺素能受体拮抗剂单独或联合用于治疗良性前列腺增生所致下尿路症状的研究。
Minerva Urol Nefrol. 2020 Feb;72(1):13-21. doi: 10.23736/S0393-2249.19.03408-8. Epub 2019 Jun 21.
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Eur Urol Focus. 2020 May 15;6(3):537-558. doi: 10.1016/j.euf.2019.05.007. Epub 2019 May 25.
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Efficacy and Safety of a Fixed-Dose Combination Therapy of Tamsulosin and Tadalafil for Patients With Lower Urinary Tract Symptoms and Erectile Dysfunction: Results of a Randomized, Double-Blinded, Active-Controlled Trial.坦索罗辛与他达拉非固定剂量联合治疗下尿路症状和勃起功能障碍患者的疗效与安全性:一项随机、双盲、活性对照试验的结果
J Sex Med. 2017 Aug;14(8):1018-1027. doi: 10.1016/j.jsxm.2017.06.006.
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Re: Efficacy and Safety of Tadalafil 5mg Once Daily in the Treatment of Lower Urinary Tract Symptoms Associated with Benign Prostatic Hyperplasia in Men Aged ≥75 years: Integrated Analyses of Pooled Data from Multinational, Randomized, Placebo-controlled Clinical Studies.关于:每日一次服用5毫克他达拉非治疗≥75岁男性良性前列腺增生相关下尿路症状的疗效和安全性:来自多国、随机、安慰剂对照临床研究的汇总数据综合分析
Eur Urol. 2017 Jun;71(6):990. doi: 10.1016/j.eururo.2017.01.027. Epub 2017 Feb 2.
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Urol J. 2016 Dec 8;13(6):2920-2926.