title: Evidence Is Enough?: A Systematic Review and Network Meta-Analysis of the Efficacy of Tamsulosin 0.2 mg and Tamsulosin 0.4 mg as an Initial Therapeutic Dose in Asian Benign Prostatic Hyperplasia Patients.
abstract: OBJECTIVE
  We compared the efficacy of tamsulosin between 0.2 mg and 0.4 mg in Asian prostatic hyperplasia (BPH) patients using network meta-analysis due to lack of studies with direct comparison.
  
  
  METHODS
  The literature search was conducted using the MEDLINE, Embase, and Cochrane Library. Keywords used were "BPH," "tamsulosin," "placebo." Experimental groups were defined as tamsulosin 0.2 mg (Tam 0.2) and 0.4 mg (Tam 0.4) and common control group was defined as placebo for indirect treatment comparison. Mixed treatment comparison was performed including one direct comparison study.
  
  
  RESULTS
  Seven studies met the eligible criteria. Indirect treatment comparison revealed that total International Prostate Symptoms Score (IPSS) and quality of life score of IPSS were not significantly different in Tam 0.2 and Tam 0.4 (P>0.05). There was no significant difference of maximal flow rate and postvoid residual urine volume in Tam 0.2 and Tam 0.4 (P>0.05). Mixed treatment comparison including one direct comparison study showed inconsistency (P<0.001). Therefore, analysis using direct treatment comparison effect sizes of Tam 0.2 vs. placebo and Tam 0.4 vs. placebo was done and there was no significant difference.
  
  
  CONCLUSIONS
  Network meta-analysis showed no difference of efficacy between tamsulosin 0.2 mg and 0.4 mg and the evidence of tamsulosin 0.4 mg as initial dose for Asian BPH patient seems to be insufficient. Therefore, initial dose of tamsulosin for Asian BPH patient should be 0.2 mg.
authors.affiliation: Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors.forename: Su Jin
authors.identifier: 0000-0002-1917-2780
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Education, Jeonju University, Jeonju, Korea.
authors.forename: In-Soo
authors.identifier: 0000-0001-7535-3511
authors.initials: IS
authors.lastname: Shin
authors.affiliation: Department of Computer Science, Gachon University, Seongnam, Korea.
authors.forename: Sung-Jong
authors.identifier: 0000-0003-3063-0452
authors.initials: SJ
authors.lastname: Eun
authors.affiliation: Department of Computer Science, Gachon University, Seongnam, Korea.
authors.forename: Taeg-Keun
authors.identifier: 0000-0003-1409-0580
authors.initials: TK
authors.lastname: Whangbo
authors.affiliation: Department of Urology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Jin Wook
authors.identifier: 0000-0003-4157-9365
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Urology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Young Sam
authors.identifier: 0000-0002-2966-7971
authors.initials: YS
authors.lastname: Cho
authors.affiliation: Department of Urology, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Bucheon, Korea.
authors.forename: Joon Chul
authors.identifier: 0000-0002-4019-620X
authors.initials: JC
authors.lastname: Kim
keywords: Asian; Dose; Men; Prostatic Hyperplasia; Tamsulosin