Efficacy and safety of muscarinic antagonists as add-on therapy for male lower urinary tract symptoms.
Alpha-adrenoceptor antagonists (alpha-blockers) are widely prescribed to treat lower urinary tract symptoms (LUTS) in men but fail to ameliorate LUTS sufficiently, especially the storage symptoms related to frequency, urgency and nocturia. We performed a meta-analysis of randomised controlled trials (RCTs) comparing an alpha-blocker plus muscarinic antagonist with an alpha-blocker alone in male LUTS patients who were treated with alpha-blocker prior to randomisation. The review contained six randomised controlled trials (RCTs) that included a total of 2,208 male patients who were randomised to receive alpha-blocker plus muscarinic antagonist or alpha-blocker alone. The add-on group experienced significantly greater improvement in both total IPSS (International Prostate Symptom Score) and storage IPSS. Adverse events (AEs) were commonly experienced by both groups (41.6 vs. 33.3%) though they were not severe. Our meta-analysis indicated that muscarinic antagonists as add-on therapy alleviate LUTS, especially storage symptoms. The add-on therapy demonstrated safety and tolerability comparable with alpha-blocker monotherapy in male with LUTS.
Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
Jinhong
J
Li
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
Qingquan
Q
Shi
Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
Yunjin
Y
Bai
Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
Chunxiao
C
Pu
Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
Yin
Y
Tang
Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
Haichao
H
Yuan
Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
Yunjian
Y
Wu
Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
Qiang
Q
Wei
Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
Ping
P
Han
D000317:Adrenergic alpha-Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000009:adverse effects / Q000627:therapeutic use*
D000317:Adrenergic alpha-Antagonists; D018727:Muscarinic Antagonists