Finasteride in the treatment of clinical benign prostatic hyperplasia: a systematic review of randomised trials.
Finasteride in the treatment of clinical benign prostatic hyperplasia: a systematic review of randomised trials.
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DOI：
10.1186/1471-2490-2-14
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发表时间：
2002-12-12
期刊：
影响因子：
2
通讯作者：
Moore, R Andrew
中科院分区：
文献类型：
--
作者：
Edwards, Jayne E;Moore, R Andrew
背景：良性前列腺增生影响老年男性。本系统评价确定的疗效和不良反应的finaldede.REVIEW方法：PubMed，科克伦图书馆，参考列表的报告，并审查了随机，双盲试验finaldede. REVIEW方法。结果包括症状评分、尿流率、前列腺体积、停药和不良反应。计算二分数据的相对危险度和NNT或NNH。敏感性分析评估了基线症状严重程度，初始前列腺体积，主导试验，和以前的interventions.RESULTS的影响：三个试验有积极的控制和19安慰剂。在安慰剂对照试验中，8820例患者在3-48个月内接受了5 mg的非那肽，5909例患者接受了安慰剂。在48个月的治疗中，芬那鲁德在总症状评分、最大尿流率和前列腺体积方面的改善更大。在12个月时，使用芬普胺的患者发生性功能障碍、阳痿、射精障碍和性欲下降的比例显著增加; 12个月时任何性功能障碍的NNH为14。与安慰剂组相比，接受非那肽治疗的男性在24个月或48个月时发生急性尿潴留或接受手术的人数明显较少;在12个月时，避免一次急性尿潴留的NNT为49（31至112），避免一次手术的NNT为31（21至61）。敏感性分析表明，无论初始前列腺volume.CONCLUSIONS：从许多患者的信息在高质量的研究中表现出有益的影响，芬那鲁德5毫克的好处是恒定的症状，流速和前列腺体积。如果以患者为中心的结局以二分形式报告，将产生更大的效用。
BACKGROUND: Benign prostatic hyperplasia affects older men. This systematic review determined efficacy and adverse effects of finasteride.REVIEW METHODS: PubMed, the Cochrane Library, reference lists of reports, and reviews were searched for randomised, double-blind trials of finasteride in benign prostatic hyperplasia. Outcomes included symptom score, urinary flow rate, prostate volume, discontinuation, and adverse effects. Relative risk and NNT or NNH were calculated for dichotomous data. Sensitivity analyses assessed influences of baseline symptom severity, initial prostate volume, a dominating trial, and previous interventions.RESULTS: Three trials had active controls and 19 had placebo. In placebo-controlled trials, 8820 patients received finasteride 5 mg and 5909 placebo over 3-48 months. Over 48 months finasteride produced greater improvements in total symptom score, maximum urinary flow rate, and prostate volume. Significantly more sexual dysfunction, impotence, ejaculation disorder and decreased libido occurred with finasteride at 12 months; the NNH for any sexual dysfunction at 12 months was 14. Significantly fewer men treated with finasteride experienced acute retention or had surgery at 24 or 48 months than with placebo; at 12 months the NNT was 49 (31 to 112) to avoid one acute urinary retention and 31 (21 to 61) to avoid one surgery. Sensitivity analyses showed benefit with finasteride 5 mg to be constant irrespective of the initial prostate volume.CONCLUSIONS: Information from many patients in studies of high quality showed beneficial effects of finasteride in terms of symptoms, flow rate and prostate volume. More utility would result if patient centred outcomes were reported in dichotomous form.