Efficacy and tolerability of doxazosin-GITS vs. tamsulosin in the treatment of patients with lower urinary tract symptoms associated with benign prostatic hyperplasia: a systematic review and meta-analysis

Research background According to current guidelines, α1-receptor blockers are the first-line treatment for men with moderate to severe lower urinary tract symptoms and benign prostatic hyperplasia (LUTS/BPH), among which doxazosin-GITS and tamsulosin are The two most commonly used clinically α1-receptor blockers
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Doxazosin-GITS accurately controls the drug release rate and changes the pharmacokinetic model, so that the drug serum concentration fluctuates less, and there is no need for titration measurement, which reduces potential adverse reactions
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The purpose of this study: To evaluate the efficacy and tolerability of doxazosin-GITS and tamsulosin in patients with LUTS/BPH through a systematic review and meta-analysis of research data published in English and Asian literature
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Research Methods: Database: PubMed, EMBASE, Cochrane Library, HowNet, Articles, VIP and so on
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 MESH search terms: RCT, doxazosin-GITS, tamsulosin, BPH, LUTS
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Inclusion criteria: inclusion criteria: RCT; direct comparison of doxazosin-GITS and tamsulosin; clinical BPH patients with LUTS; at least one result of interest in this study or the possibility of extracting relevant data for calculation Sex
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Exclusion criteria: non-RCT; suffering from other urinary system diseases except LUTS/BPH; received antimuscarinic drugs, cholinergic drugs, other α1-receptor blockers, 5α-reduction in the past 6 months Combination therapy with enzyme inhibitors or antiandrogens; no meaningful results reported or unable to calculate the necessary indicators for inference; cohort, case control or case report, comment or editorial
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Study quality: Use the Jadad scale and Cochrane risk of bias to assess the quality of the selected RCTs
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The Jadad scale scores four aspects: random sequence generation, random concealment, blind design, and withdrawal/drop-out.
RCTs with a total score of less than 3 are assessed as "low" methodological quality
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Cochrane's risk of bias includes 7 items of bias, including selection bias and reporting bias.
7 items are deemed to be low risk of bias, and at least 1 item of the 7 items is judged to be high risk of bias
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Main research results The characteristics of the selected RCTs: According to the inclusion and exclusion criteria, 8 RCTs were selected from 222 studies for meta-analysis.
A total of 1,316 patients were included for a follow-up period of 8 to 20 weeks, and each trial included 52 to 207 people
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Four RCTs are in China, two are in South Korea, one is in the UK, and one is in Brazil
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 Efficacy comparison: the doxazosin-GITS group of patients in the International Prostate Symptom Score (IPSS-T), Urinary Storage Symptom Score (IPSS-S), Urinary Symptom Score (IPSS-V) were all improved by bistamsulo The Xin group was more significant
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Comparison of safety and tolerability: Compared with tamsulosin in the doxazosin-GITS group, the incidence of overall adverse events (AE) was significantly lower
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 Compared with tamsulosin in the doxazosin-GITS group, there was no significant difference in the incidence of orthostatic hypotension
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Conclusion The results of this meta-analysis show that for LUTS/BPH patients, doxazosin-GITS has better efficacy and lower AEs than tamsulosin
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References Guo J, Tang R.
Efficacy and tolerability of doxazosin gastro-intestinal therapeutic system versus tamsulosin in patients with lower urinary tract symptoms associated with benign prostatic hyperplasia: A systematic review and meta-analysis.
Medicine (Baltimore).
2021; 100( 33): e26955.