Naftopidil for the treatment of lower urinary tract symptoms compatible with benign prostatic hyperplasia

摘要: BACKGROUND Benign prostatic hyperplasia (BPH) is a common condition in ageing men that may cause lower urinary tract symptoms (LUTS). Treatment aims are to relieve and prevent disease-related complications. Naftopidil an alpha-blocker (AB) has high affinity for the A1d receptor have advantages treating LUTS this setting. This update of Cochrane Review first published 2009. Since time, several large randomised controlled trials (RCTs) been reported, making relevant. OBJECTIVES To evaluate effects naftopidil treatment associated with BPH. SEARCH METHODS We performed comprehensive search using multiple databases (the Library, MEDLINE, Embase, Scopus, LILAC, Web Science), registries, other sources grey literature, conference proceedings no restrictions on language publication or status up 31 May 2018 SELECTION CRITERIA: included all parallel RCTs. also cross-over design trials. DATA COLLECTION AND ANALYSIS Two review authors independently classified abstracted data from studies. statistical analyses random-effects model interpreted them according Handbook Systematic Reviews Interventions. Primary outcomes were urological symptom scores, quality life (QoL) withdrawals any reason; secondary due adverse events, acute retention, surgical intervention BPH, cardiovascular sexual events. considered measured 12 months after randomisation as short term, later than long term. rated certainty evidence GRADE approach. MAIN RESULTS 22 RCTs 2223 participants across four comparisons short-term follow-up. abstract focuses only two which we found since comparators (i.e. propiverine Eviprostat (phytotherapy)) rarely used. One study comparing placebo did not report relevant was therefore excluded. There compared combination therapy 5-alpha reductase inhibitors (5-ARIs) ABs 5-ARIs.All studies conducted Asian countries. Study duration ranged weeks. Mean age 67.8 years, prostate volume 35.4 mL, International Prostate Symptom Score 18.3. unable perform preplanned subgroup based baseline score.Naftopidil versus tamsulosinBased 965 participants, resulted little difference score (mean (MD) 0.47, 95% confidence interval (CI) -0.09 1.04 scale 0 35 higher representing increased symptoms), QoL (MD 0.11, CI 0.30; 6 scores worse QoL), reason (risk ratio (RR) 0.92, 0.64 1.34; corresponding 7 fewer per 1000 32 more). events (RR 0.54, 0.24 1.22); would result 26 (95% 43 13 moderate low outcomes.Naftopidil silodosinBased five 652 1.04, -0.78 2.85), 0.21, -0.23 0.66), 0.80, 0.52 1.23; 62 these outcomes. likely reduced 0.15, 0.06 0.42; 126 139 86 fewer). AUTHORS' CONCLUSIONS appears similar tamsulosin silodosin. but