Silodosin is effective for treatment of LUTS in men with BPH: A systematic review

Institute of Urology, Key Laboratory of Diseases of Urological System Gansu Province, Gansu Nephro-Urological Clinical Center, The Second Hospital of Lanzhou University, Lanzhou, China.
Cellular & molecular immunology (Impact Factor: 4.11). 12/2012; 15(1). DOI: 10.1038/aja.2012.102
Source: PubMed


The aim of this study was to systematically review the evidence on the efficacy and safety of silodosin treatments on lower urinary tract symptoms (LUTS) in men with benign prostatic hyperplasia (BPH) from randomized controlled trials. We searched PubMed (1966-December 2011), Embase (1974-December 2011) and the Cochrane Library Database (2011, Issue 12). The assessed outcome measures were the change from baseline for the International Prostate Symptom Score (IPSS), quality of life (QoL) score, peak urine maximum flow rate (Q(max)), QoL related to urinary symptoms and adverse effects. Two authors independently assessed the study quality and extracted data. All data were analysed using RevMan 5.1. The meta-analysis included four randomized controlled trials with a total of 2504 patients. The study durations were each 12 weeks. At the follow-up end points, the pooled results showed that the change from baseline for the silodosin group was significantly higher than the placebo group for the IPSS, QoL score and Q(max)(mean difference (MD)=-2.78, P<0.00001; MD=-0.42, P=0.004; MD=1.17, P<0.00001,respectively) and patients felt more satisfied with QoL related to urinary symptoms in the silodosin group than the placebo group. Ejaculation disorder was the most commonly reported adverse effect. The pooled results also showed that the silodosin group was superior to the 0.2 mg tamsulosin group with respect to the IPSS and QoL score (IPSS: MD=-1.14, P=0.02; QoL score: MD=-0.26, P=0.02) and inferior to the 0.2 mg tamsulosin group with respect to Q(max) (MD=-0.85, P=0.01). In contrast, there was no significant difference in the incidence of ejaculation disorder and dizziness between the silodosin and 0.2 mg tamsulosin groups. The current meta-analysis suggested that silodosin is an effective therapy for LUTS in men with BPH and is not inferior to 0.2 mg tamsulosin.Asian Journal of Andrology advance online publication, 10 December 2012; doi:10.1038/aja.2012.102.

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    • "Combination therapy of α-blocker and anticholinergics is frequently used to treat storage symptoms, but this clinical study has shown silodosin to be an effective monotherapy in treating storage symptoms of BPH by relieving not only the voiding symptoms but also the storage symptoms. The efficacy of silodosin may result from the reduction of obstruction at the bladder outlet by α1A-adrenoceptor antagonists during voiding as there are α1A-adrenoceptors at the bladder neck and proximal urethra [12,13,14,15]. "
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    ABSTRACT: Purpose To evaluate the efficacy and safety of silodosin 8 mg once daily in a 12-week treatment of subjects with severe lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). Materials and Methods A total of 100 subjects from 10 urology centers in Korea were included in this study. The inclusion criteria were as follows: age ≥50 years, International Prostate Symptom Score (IPSS) ≥20, quality of life (QoL) score ≥3, urine volume ≥120 mL and maximal urinary flow rate (Qmax) <15 mL/s, and postvoid residual volume (PVR) <100 mL. We assessed the improvement of LUTS with change in IPSS, QoL score, Qmax, PVR, and adverse events at baseline and 4 and 12 weeks after treatment with silodosin 8 mg once daily. Results The IPSS values were 23.27±3.34, 15.89±6.26, and 13.80±6.31 at baseline, 4, and 12 weeks, respectively, with significant improvements (p<0.0001, p=0.0214, respectively). QoL scores were 4.44±0.85, 3.38±1.20, and 3.04±1.20 at baseline, 4, and 12 weeks, respectively, and the differences were statistically significant (p<0.0001). There was a significant difference in Qmax between baseline and 12 weeks (p<0.0001) but not in PVR (p=0.9404) during the clinical trial. The most frequent adverse event in this study was ejaculation failure with 13 cases. However, no subject dropped out because of ejaculation failure, and in 12 of the 13 cases it was fully resolved without further treatment. Conclusions Silodosin 8 mg once daily may be effective and safe in Korean patients with severe LUTS associated with BPH.
    Full-text · Article · May 2014 · Korean journal of urology
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    • "La surveillance sans intervention thérapeutique est la stratégie préconisée pour les patients ayant des SBAU légers non gênants et conformément aux recommandations françaises et européennes de l'EAU, les alpha-bloquants sont des traitements de première intention pour des SBAU modérés ou sévères gênants [6] [7]. La silodosine est un alpha-bloquant avec une grande affinité pour les récepteurs adrénergiques ␣ 1A situés au niveau du bas appareil urinaire [8]. L'affinité de la silodosine est 162 fois plus forte pour les récepteurs ␣ 1A que pour les récepteurs ␣ 1B principalement situés au niveau vasculaire [9]. "
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    ABSTRACT: The objective of this study was to analyze the efficacy and safety of silodosin in patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) in current urologic practice. This was a prospective observational study conducted by 272 urologists on patients treated by silodosin for BPH. The parameters evaluated were the weighted IPSS score, the IPSS question 8 related to quality of life, the USP score and the Athens Insomnia Scale (AIS) measured at treatment initiation and after 3months. Nine hundred and fourteen patients whose average age was 66 years with LUTS for 3.3 years were analyzed. After 3 months of treatment, a significant decrease in IPSS (from 16.2±6.1 to 9.7±5.5, P<0.0001) and USP score (from 10.6±5.1 to 6 0±4.6, P<0.0001) were observed, quality of life (from 67.1% to 14.4% of unsatisfied patients, P<0.0001) and sleep were significantly improved (from 49.2% to 28.9% patients with insomnia, P<0.0001). Among the patients, 21.2% experienced at least one adverse event. The most frequent were abnormal ejaculation (17.2%). And 7.1% discontinued the treatment for this reason. After 3months of treatment silodosin was continued in 86.9% of patients. This large study confirmed the efficacy of silodosin in LUTS associated with BPH with a safety profile that does not affect patient satisfaction.
    Full-text · Article · Mar 2014 · Progrès en Urologie
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    • "Alpha-1 blockers are the first option for the medical treatment of LUTS caused by BPH (Takahashi 2011). Alpha 1-adrenoceptor antagonists (α-blockers) remain the most widely used pharmacologic agents for treating bladder outflow resistance caused by BPH (Perabo 2012, Shrivastava 2013).The amount of prescriptions for α-blockers has been increasing steadily in the last 10 years (Ding 2013, Shrivastava & Aggrawal 2013). Currently, five α-blockers are used: alfuzosin, doxazosin, sildosin, tamsulosin, terazosin (Shrivastava 2014). "
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    ABSTRACT: Doxazosin mesylate is used in the management of hypertension and benign prostatic hyperplasia. It is one of the important alpha one adrenoreceptor blocker. Alpha one adrenoreceptor blockers are most preferred therapy for symptomatic relief of benign prostatic hyper-plasia. In this review analytical methods for the determination of doxazosin in different matrices are discussed. Analytical methods are classified in to spectrophotometry, chromatography and electroanalytical methods. This literature is also focused on advantages, disad-vantages of different analytical methods. This review article is an attempt to provide information to the scientists engaged in research related to doxazosin.
    Full-text · Article · Feb 2014
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