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

Hyun Jung Kim, Hwa Yeon Sun, Hoon Choi, Jae Young Park, Jae Hyun Bae, Seung Whan Doo, Won Jae Yang, Yun Seob Song, Young Myoung Ko, Jae Heon Kim

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

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.

Original languageEnglish
Article numbere0169248
JournalPLoS One
Volume12
Issue number1
DOIs
Publication statusPublished - 2017 Jan 1

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Lower Urinary Tract Symptoms
urinary tract
Prostatic Hyperplasia
Cholinergic Antagonists
hyperplasia
meta-analysis
signs and symptoms (animals and humans)
drug therapy
Residual Volume
Meta-Analysis
Surface mount technology
Safety
Prostate
Quality of Life
quality of life
Urinary Retention
Deterioration
Therapeutics
Flow rate
Sample Size

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

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.

In: PLoS One, Vol. 12, No. 1, e0169248, 01.01.2017.

Research output: Contribution to journalArticle

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abstract = "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.",
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AU - Kim, Hyun Jung

AU - Sun, Hwa Yeon

AU - Choi, Hoon

AU - Park, Jae Young

AU - Bae, Jae Hyun

AU - Doo, Seung Whan

AU - Yang, Won Jae

AU - Song, Yun Seob

AU - Ko, Young Myoung

AU - Kim, Jae Heon

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Y1 - 2017/1/1

N2 - 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.

AB - 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.

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