EVALUATING THE EFFECTS OF TADALAFIL ON LOWER URINARY TRACT SYMPTOMS DUE TO BENIGN PROSTATIC HYPERPLASIA: A SYSTEMATIC REVIEW AND META-ANALYSIS
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Abstract
Objective: This review aims to assess tadalafil's efficacy and safety in managing BPH-LUTS, providing insights for clinical practice. Material & Methods: A systematic search strategy was conducted across several electronic reference databases (PubMed, Google Scholar, Proquest, and Cochrane) and included articles published between 2014-2024. Duplicate publications, review articles, and incomplete articles were excluded. Results: Database search yielded 302 articles, which were systematically eliminated, leaving 10 relevant articles. A total of 1.645 patients were involved in the 10 included studies. Of the 10 included studies, 9 were single-center studies and 1 was a multi-center study. Of all the studies, 7 were randomized controlled trials, 2 were observational trials, and 1 was a cohort study. From the meta-analysis test, it was found that the increase in IPSS 12 weeks after therapy was no different when administering tadalafil and tamsulosin. Conclusion: In conclusion, tadalafil monotherapy demonstrates comparable efficacy to tamsulosin in treating LUTS/BPH, with its approval stemming from its effectiveness in managing ED. The IPSS score between tadalafil and tamsulosin is considered similar statistically. Studies suggest synergistic effects when combined with alpha-blockers, offering promise for patients with concurrent conditions. Safety findings support its utility across diverse populations. Keywords: BPH, LUTS, tadalafil.
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BPH, LUTS, Tadalafil
Devlin CM, Simms MS, Maitland NJ. Benign prostatic hyperplasia – what do we know? BJU Int. 2021 Apr 24;127(4):389–99.
Stefanus D, Siregar S. Association of Lower Urinary Tract Symptoms and Benign Prostatic Enlargement in Patients with Hypertension. Maj Kedokt Bandung. 2023;55(1):47–52.
Goel A. Lower urinary tract symptoms and benign prostatic hyperplasia: From research to bedside. Indian J Med Res. 2019;149(5):684.
O’Quin C, White KL, Campbell JR, Myers SH, Patil S, Chandler D, et al. Pharmacological Approaches in Managing Symptomatic Relief of Benign Prostatic Hyperplasia: A Comprehensive Review. Cureus [Internet]. 2023 Dec 30; Available from: https://www.cureus.com/articles/207890-pharmacological-approaches-in-managing-symptomatic-relief-of-benign-prostatic-hyperplasia-a-comprehensive-review
Pirozzi L, Sountoulides P, Castellan P, Presicce F, Lombardo R, Romero M, et al. Current Pharmacological Treatment for Male LUTS due to BPH: Dutasteride or Finasteride? Curr Drug Targets. 2015 Oct 13;16(11):1165–71.
Yokoyama O, Igawa Y, Takeda M, Yamaguchi T, Murakami M, Viktrup L. Tadalafil for lower urinary tract symptoms secondary to benign prostatic hyperplasia: a review of clinical data in Asian men and an update on the mechanism of action. Ther Adv Urol. 2015 Oct 24;7(5):249–64.
Dong Y, Hao L, Shi Z, Wang G, Zhang Z, Han C. Efficacy and Safety of Tadalafil Monotherapy for Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: A Meta-Analysis. Urol Int. 2013;91(1):10–8.
Brock G, Broderick G, Roehrborn CG, Xu L, Wong D, Viktrup L. Tadalafil once daily in the treatment of lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) in men without erectile dysfunction. BJU Int. 2013 Nov;112(7):990–7.
AbdelRazek M, Abolyosr A, Mhammed O, Fathi A, Talaat M, Hassan A. Prospective comparison of tadalafil 5 mg alone, silodosin 8 mg alone, and the combination of both in treatment of lower urinary tract symptoms related to benign prostatic hyperplasia. World J Urol. Springer Berlin Heidelberg; 2022;40(8):2063–70.
Sebastianelli A, Spatafora P, Frizzi J, Saleh O, De Nunzio C, Tubaro A, et al. Which Drug to Discontinue 3 Months After Combination Therapy of Tadalafil plus Tamsulosin for Men with Lower Urinary Tract Symptom and Erectile Dysfunction? Results of a Prospective Observational Trial. Eur Urol Focus. European Association of Urology; 2021;7(2):432–9.
M. Nasef O, E. Ebid AE-R, K. Koritenah A. Effect of Tadalafil Add-on Therapy in Patients With Lower Urinary Tract Symptoms Due To Benign Prostatic Hyperplasia Refractory To Tamsulosin Monotherapy: Randomized, Controlled Trial. Al-Azhar Med J. 2021;50(3):1659–70.
Nagasubramanian S, John NT, Antonisamy B, Mukha RP, Jeyachandra Berry CS, Kumar S, et al. Tamsulosin and placebo vs tamsulosin and tadalafil in male lower urinary tract symptoms: a double-blinded, randomised controlled trial. BJU Int. 2020;125(5):718–24.
Negoro H, Goto T, Akamatsu S, Terada N, Kobayashi T, Matsui Y, et al. Add-on effects of tadalafil in tamsulosin-treated patients with small benign prostatic enlargement: A randomized, placebo-controlled, double-blind, crossover study. Neurourol Urodyn. 2020;39(1):237–42.
Sebastianelli A, Spatafora P, Frizzi J, Saleh O, Sessa M, De Nunzio C, et al. Tadalafil 5 mg alone or in combination with tamsulosin 0.4 mg for the management of men with lower urinary tract symptoms and erectile dysfunction: Results of a prospective observational trial. J Clin Med. 2019;8(8):4–13.
Matsukawa Y, Takai S, Majima T, Funahashi Y, Sassa N, Kato M, et al. Objective impacts of tadalafil on storage and voiding function in male patients with benign prostatic hyperplasia: 1-year outcomes from a prospective urodynamic study. World J Urol. Springer Berlin Heidelberg; 2019;37(5):867–72.
Zhang Z, Li H, Zhang X, Dai Y, Park HJ, Jiann BP, et al. Efficacy and safety of tadalafil 5 mg once-daily in Asian men with both lower urinary tract symptoms associated with benign prostatic hyperplasia and erectile dysfunction: A phase 3, randomized, double-blind, parallel, placebo- and tamsulosin-controlled s. Int J Urol. 2019;26(2):192–200.
Pogula VR, Kadiyala LS, Gouru VR, Challa SR, Byram R, Bodduluri S. Tadalafil vs. tamsulosin in the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia: A prospective, randomized study. Cent Eur J Urol. 2019;72(1):44–50.
Pattanaik S, Sandhu H, Mavuduru R, Singh S, Mandal A. Efficacy of tamsulosin and tadalafil in relieving benign prostatic hyperplasia related symptoms: A randomized double blind placebo controlled cross-over study. Indian J Urol. 2019;35(1):25–33.
Gratzke C, Bachmann A, Descazeaud A, Drake MJ, Madersbacher S, Mamoulakis C, et al. EAU Guidelines on the Assessment of Non-neurogenic Male Lower Urinary Tract Symptoms including Benign Prostatic Obstruction. Eur Urol. 2015 Jun;67(6):1099–109.
Qiangzhao L, Xiaofeng Z, Fenghai Z, Qiong L, Fa Z, Bohong G, et al. Efficacy and tolerability of combination therapy with alpha-blockers and phosphodiesterase-5 inhibitors compared with monotherapy for lower urinary tract symptoms. Medicine (Baltimore). 2020 Oct 23;99(43):e22834.
Oelke M, Giuliano F, Mirone V, Xu L, Cox D, Viktrup L. Monotherapy with Tadalafil or Tamsulosin Similarly Improved Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia in an International, Randomised, Parallel, Placebo-Controlled Clinical Trial. Eur Urol. 2012 May;61(5):917–25.
Lerner LB, McVary KT, Barry MJ, Bixler BR, Dahm P, Das AK, et al. Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA GUIDELINE PART I—Initial Work-up and Medical Management. J Urol. 2021 Oct;206(4):806–17.
Gacci M, Sebastianelli A, Salvi M, Vignozzi L, Corona G, McVary KT, et al. PDE5-Is for the Treatment of Concomitant ED and LUTS/BPH. Curr Bladder Dysfunct Rep. 2013 Jun 2;8(2):150–9.
Roehrborn CG, Barkin J, Tubaro A, Emberton M, Wilson TH, Brotherton BJ, et al. Influence of baseline variables on changes in International Prostate Symptom Score after combined therapy with dutasteride plus tamsulosin or either monotherapy in patients with benign prostatic hyperplasia and lower urinary tract symptoms: 4-year results. BJU Int. 2014 Apr 9;113(4):623–35.
Choi WS, Son H. The change of IPSS 7 (nocturia) score has the maximum influence on the change of Qol score in patients with lower urinary tract symptoms. World J Urol. 2019 Apr 2;37(4):719–25.
Kim SW, Park NC, Lee SW, Yang DY, Park JK, Moon DG, et al. Efficacy and Safety of a Fixed-Dose Combination Therapy of Tamsulosin and Tadalafil for Patients with Lower Urinary Tract Symptoms and Erectile Dysfunction: Results of a Randomized, Double-Blinded, Active-Controlled Trial. J Sex Med. 2017 Aug 1;14(8):1018–27.
Kallidonis P, Adamou C, Kotsiris D, Ntasiotis P, Verze P, Athanasopoulos A. Combination Therapy with Alpha-blocker and Phosphodiesterase-5 Inhibitor for Improving Lower Urinary Tract Symptoms and Erectile Dysfunction in Comparison with Monotherapy: A Systematic Review and Meta-analysis. Eur Urol Focus. 2020 May;6(3):537–58. A
Broderick GA, Brock GB, Roehrborn CG, Watts SD, Elion-Mboussa A, Viktrup L. Effects of Tadalafil on Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia in Men With or Without Erectile Dysfunction. Urology. 2010 Jun;75(6):1452–7.