A pooled analysis of individual patient data from registrational trials of silodosin in the treatment of non-neurogenic male lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH)

被引:20
作者
Novara, Giacomo [1 ]
Chapple, Christopher R. [3 ]
Montorsi, Francesco [2 ]
机构
[1] Univ Padua, Urol Clin, Dept Oncol Surg & Gastroenterol Sci, I-35100 Padua, Italy
[2] Univ Vita Salute San Raffaele, San Raffaele Sci Inst, Urol Res Inst, Dept Urol, Milan, Italy
[3] Royal Hallamshire Hosp, Sheffield S10 2JF, S Yorkshire, England
关键词
benign prostatic hyperplasia (BPH); lower urinary tract symptoms (LUTS); silodosin; alpha-blockers; ALPHA(1A)-ADRENOCEPTOR-SELECTIVE ANTAGONIST; DOUBLE-BLIND; METAANALYSIS; EFFICACY; MEN; MANAGEMENT; PROFILE; SAFETY; EUROPE;
D O I
10.1111/bju.12712
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Objective To evaluate the efficacy and safety of silodosin in a pooled analysis based on individual patients data from three randomised controlled trials (RCTs) comparing silodosin and placebo. Patients and methods A pooled analysis of 1494 patients from three 12-week, similarly designed, parallel-group, multicentre, randomised, double-blind, placebo-controlled phase III RCTs (SI04009, SI04010, KMD3213-IT-CL 0215) was performed. Differences from placebo for the mean change from baseline to the end of treatment for the International Prostate Symptom Score (IPSS) and uroflowmetry data were tested using an analysis of covariance model. Results At study end, in the intention-to-treat population, silodosin was significantly more effective than placebo in improving IPSS total score (adjusted means differences [AMD] 2.7; P < 0.001). Silodosin was significantly more effective than placebo in improving storage, voiding, and quality-of-life-item subscores (all P < 0.001). Similarly, silodosin was more effective than placebo in improving maximum urinary flow rate (Q(max); AMD 0.8; P = 0.002). The most frequently reported adverse event (AE) was ejaculatory dysfunction, reported in 186 (22%) patients in the silodosin group and six (0.9%) in the placebo group (odds ratio 28.14; P < 0.001). Dizziness and orthostatic hypotension rates were similar in silodosin and placebo groups. Conclusions Silodosin is an effective treatment for male lower urinary tract symptoms suggestive of benign prostatic hyperplasia. The drug is able to improve total IPSS, all IPSS-related parameters, and Q(max) at uroflowmetry. Ejaculatory dysfunction is the main treatment-related AE, whereas prevalence of cardiovascular AEs was similar to placebo.
引用
收藏
页码:427 / 433
页数:7
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