The Resource Newer medications for lower urinary tract symptoms attributed to benign prostatic hyperplasia : a review, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Minnesota Evidence-based Practice Center ; investigators, Michelle Brasure, Roderick MacDonald, Philipp Dahm, Carin M. Olson, Victoria A. Nelson, Howard A. Fink, Michael Risk, Bruce Rwabasonga, Timothy J. Wilt

Newer medications for lower urinary tract symptoms attributed to benign prostatic hyperplasia : a review, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Minnesota Evidence-based Practice Center ; investigators, Michelle Brasure, Roderick MacDonald, Philipp Dahm, Carin M. Olson, Victoria A. Nelson, Howard A. Fink, Michael Risk, Bruce Rwabasonga, Timothy J. Wilt

Label
Newer medications for lower urinary tract symptoms attributed to benign prostatic hyperplasia : a review
Title
Newer medications for lower urinary tract symptoms attributed to benign prostatic hyperplasia
Title remainder
a review
Statement of responsibility
prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Minnesota Evidence-based Practice Center ; investigators, Michelle Brasure, Roderick MacDonald, Philipp Dahm, Carin M. Olson, Victoria A. Nelson, Howard A. Fink, Michael Risk, Bruce Rwabasonga, Timothy J. Wilt
Title variation
Effective Health Care Program
Creator
Contributor
Author
Issuing body
Sponsoring body
Subject
Genre
Language
eng
Summary
OBJECTIVE: To assess the efficacy, comparative effectiveness, and adverse effects of newer drugs to treat lower urinary tract symptoms (LUTS) attributed to benign prostatic hyperplasia (BPH). DATA SOURCES: Ovid MEDLINE(r), the Cochrane Central Register of Controlled Trials, and Ovid Embase(r) bibliographic databases; hand searches of references of relevant studies. REVIEW METHODS: We searched bibliographic databases through July 2015. Two investigators screened titles and abstracts of search results and full text of relevant references for eligibility. Eligible studies evaluated efficacy and/or harms of one alpha blocker (AB) (silodosin), several antimuscarinics (tolterodine, solifenacin, fesoterodine), one beta-3 adrenoceptor agonist (mirabegron), and several phosphodiesterase type 5 (PDE-5) inhibitors (tadalafil, sildenafil) or combination therapy with one of these medications. They included randomized controlled trials (RCTs) with duration of at least 1 month and observational studies for long-term (e1 year) adverse events. We assessed risk of bias for RCTs, extracted data, pooled data for analysis when appropriate and feasible, and evaluated strength of evidence for comparisons on an outcome-specific basis. RESULTS: We synthesized evidence from 57 unique RCTs and 5 observational studies. Trials were generally short term (e.g., 12 weeks). Silodosin was more effective than placebo in improving LUTS but was similar to tamsulosin and had more adverse effects, including abnormal ejaculation. Solifenacin/AB combination therapy was better than placebo, but tolterodine/AB, solifenacin/AB, and fesoterodine/AB combination therapy were similar to AB monotherapy, and combination therapy often had more adverse effects. Tadalafil improved LUTS more than placebo but had more adverse effects. Tadalafil and tamsulosin were similar in improving LUTS. We identified trials testing other drugs (mirabegron, oxybutynin, darifenacin, sildenafil, and vardenafil) but found the evidence insufficient to draw conclusions about efficacy, comparative effectiveness, or adverse effects. Evidence was insufficient to assess long-term efficacy, prevention of symptom progression (e.g., acute urinary retention or need for surgical intervention), or adverse effects. CONCLUSIONS: Several drugs newly used for LUTS attributed to BPH, alone or in combination with older AB, showed evidence of efficacy in short-term studies; however, comparative effectiveness for silodosin, fesoterodine/AB combination, and tadalafil showed that outcomes were similar to older AB monotherapy and adverse effects were often higher with the newly used drugs or combination therapies. Evidence on long-term efficacy and adverse effects was insufficient
Member of
Cataloging source
NLM
http://library.link/vocab/creatorName
Brasure, Michelle
Funding information
Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services 5600 Fishers Lane, Rockville, MD 20857; www.ahrq.gov. Contract No. 290-2012-00161-I. Prepared by: Minnesota Evidence-based Practice Center, Minneapolis, MN
Government publication
federal national government publication
Illustrations
illustrations
Index
no index present
Literary form
non fiction
Nature of contents
  • dictionaries
  • surveys of literature
NLM call number
WJ 752
http://library.link/vocab/relatedWorkOrContributorName
  • Effective Health Care Program (U.S.)
  • Minnesota Evidence-based Practice Center
  • United States
Series statement
  • Comparative effectiveness review
  • AHRQ publication
Series volume
  • number 178
  • no. 16-EHC024-EF
http://library.link/vocab/subjectName
  • Lower Urinary Tract Symptoms
  • Prostatic Hyperplasia
  • Urological Agents
  • Urological Agents
  • Treatment Outcome
  • Comparative Effectiveness Research
Label
Newer medications for lower urinary tract symptoms attributed to benign prostatic hyperplasia : a review, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Minnesota Evidence-based Practice Center ; investigators, Michelle Brasure, Roderick MacDonald, Philipp Dahm, Carin M. Olson, Victoria A. Nelson, Howard A. Fink, Michael Risk, Bruce Rwabasonga, Timothy J. Wilt
Instantiates
Publication
Note
"May 2016."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
  • cr
Carrier MARC source
rdacarrier
Content category
  • text
  • still image
Content type code
  • txt
  • sti
Content type MARC source
  • rdacontent
  • rdacontent
Control code
955092921
Extent
1 online resource (various paging)
Form of item
online
Media category
computer
Media MARC source
rdamedia
Media type code
  • c
Other physical details
illustrations.
Specific material designation
remote
System control number
(OCoLC)955092921
Label
Newer medications for lower urinary tract symptoms attributed to benign prostatic hyperplasia : a review, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Minnesota Evidence-based Practice Center ; investigators, Michelle Brasure, Roderick MacDonald, Philipp Dahm, Carin M. Olson, Victoria A. Nelson, Howard A. Fink, Michael Risk, Bruce Rwabasonga, Timothy J. Wilt
Publication
Note
"May 2016."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
  • cr
Carrier MARC source
rdacarrier
Content category
  • text
  • still image
Content type code
  • txt
  • sti
Content type MARC source
  • rdacontent
  • rdacontent
Control code
955092921
Extent
1 online resource (various paging)
Form of item
online
Media category
computer
Media MARC source
rdamedia
Media type code
  • c
Other physical details
illustrations.
Specific material designation
remote
System control number
(OCoLC)955092921

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