Evidence map›Paper›PMID 37789333›Full record

SynthesisBMC urology2023

Comparison of add-on medications for persistent storage symptoms after α-blocker treatment in BPH patients - a network meta-analysis.

Yi-Ting Su, Hsiao-Ling Chen, Jeremy Yuen-Chun Teoh, Vinson Wai-Shun Chan, Wen-Jeng Wu, Hsiang-Ying Lee

Open access · goldAbstract readSystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in BMC urology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 3 countries.

Yi-Ting SuDepartment of Urology, Mackay Memorial Hospital, Taipei, Taiwan.
Hsiao-Ling ChenInstitute of Health and Welfare Policy, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Jeremy Yuen-Chun TeohDepartment of Surgery, S.H. Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China.
Vinson Wai-Shun ChanRoyal Derby Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK.
Wen-Jeng WuDepartment of Urology, Kaohsiung Medical University Hospital, No. 100, Shih-Chuan 1St Road, Sanmin Dist., Kaohsiung, 80708, Taiwan.
Hsiang-Ying LeeDepartment of Urology, Kaohsiung Medical University Hospital, No. 100, Shih-Chuan 1St Road, Sanmin Dist., Kaohsiung, 80708, Taiwan. ashum1009@hotmail.com.
Kaohsiung Medical University Chung-Ho Memorial Hospital · TWChinese University of Hong Kong · CNMackay Memorial Hospital · TWNational Yang Ming Chiao Tung University · TWRoyal Derby Hospital · GB

Funding

Kaohsiung Medical University Chung-Ho Memorial Hospital KMUH-111-1R55Ministry of Science and Technology, Taiwan MOST-111-2314-B-037-100-MY2Regenerative Medicine and Cell Therapy Research Center KMU-TC112A02
6 · The paper itself

Abstract

backgroundPatients with benign prostatic hyperplasia (BPH) receive α-blockers as first-line therapy to treat lower urinary tract symptoms; however, some individuals still experience residual storage symptoms. Antimuscarinics, β3-agonists, and desmopressin are effective add-on medications. Nevertheless, there is currently no evidence for the appropriate choice of the first add-on medication. This systematic review aimed to investigate the clinical benefits of antimuscarinics, β3-agonists, and desmopressin, in addition to α-blockers, for persistent storage symptoms in BPH patients.

methodsA comprehensive literature search of randomized controlled trials (RCTs) comparing the efficacy of different add-on medications in BPH patients with persistent storage symptoms despite α-blocker treatment was conducted. Clinical outcomes included the International Prostate Symptom Score (IPSS), IPSS storage subscore, nocturia, micturition, and urgency. A network meta-analysis was performed to estimate the effect size. Surface under cumulative ranking curves (SUCRAs) were used to rank the included treatments for each outcome.

resultsA total of 15 RCTs were identified. Add-on imidafenacin and mirabegron resulted in significant improvement in all outcomes assessed. Other add-on medications such as desmopressin, tolterodine, solifenacin, fesoterodine, and propiverine showed positive benefits for most, but not all, outcomes. Based on the SUCRA rankings, add-on desmopressin was the best-ranked treatment for IPSS and nocturia, and add-on imidafenacin was the best for the IPSS storage subscore and micturition.

conclusionsBPH patients presenting with persistent storage symptoms despite α-blocker administration are recommended to include additional treatment. Desmopressin and imidafenacin may be considered high-priority add-on treatments because of their superior efficacy compared with other medications.

Indexed as

Lower Urinary Tract SymptomsNocturiaProstatic HyperplasiaAdrenergic alpha-AntagonistsDeamino Arginine VasopressinDrug Therapy, CombinationHumansMaleMuscarinic AntagonistsTreatment OutcomeAdrenergic alpha-AntagonistsDeamino Arginine VasopressinMuscarinic AntagonistsAdd-on medicationsAlpha-blockersBenign prostatic hyperplasiaNetwork meta-analysisStorage symptoms

Identifiers

PMID37789333
PMCPMC10546657
OpenAlexW4387312420

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.