The Efficacy and Safety of Dutasteride and Finasteride in Patients With Benign Prostatic Hyperplasia

A Systematic Review and Meta-Analysis

Yao Li; Jie Ma; Xin-Hua Qin; Chuan-Yi Hu

Disclosures

Transl Androl Urol. 2022;11(3):313-324. 

In This Article

Methods

Inclusion Criteria

Patients. Men between the ages of 50 and 70 with obvious symptoms of prostatic hyperplasia [IPSS >8; average urination time <12 mL/s; a diagnosis of prostate hyperplasia confirmed by prostate B-ultrasound or computed tomography (CT) examination] were identified as subjects.[8]

Intervention. Intervention was based on dutasteride or finasteride were included in our study.

Comparator. Comparator was the pharmacological therapy that either dutasteride or finasteride applied to patients.

Outcomes. Outcomes included the assessment of IPSS, maximum urinary flow rate (Qmax), prostate volume (PV), quality of life (QOL), PSA and adverse drug reactions (ADRs).

Study Design. Study design was randomized controlled trials (RCTs) of dutasteride versus finasteride in the treatment of BPH. The origin of the scientific legend was traced, and the language was limited to English or Chinese.

Exclusion Criteria

(I) Reviews, case-control studies, systematic evaluations and letters were excluded; (II) duplicate publications or articles with no available data were excluded.

Search Strategy

A search of relevant articles was conducted from January 2009 to July 2021 using the electronic databases PubMed, Embase, Medline, Cochrane Library, China Academic Journals Full-text Database (CJFD), Chinese Science and Technology Journal Database (VIP) and Wanfang Database. Search terms included "Benign Prostatic hyperplasia", "Random", "Control", "Dutasteride", "Finasteride", "Adult" and "Male".

Data Extraction and Quality Assessment

Two researchers independently screened the titles and abstracts for eligibility. When there was a difference of opinion, a third reviewer was consulted. The authors were contacted about missing or unclear data. The risk of bias and literature quality were evaluated according to the Cochrane Systematic Review:[9] (I) RCT; (II) allocation scheme; (III) blind method; (IV) complete data; (V) selection bias; and (VI) other biases. For RCTs, we used the Jadad scale with the classification criteria of high quality (3 or more) and low quality (2 or less).

Statistical Analysis

Meta-analyses were carried out using RevMan version 5.0 statistical processing software. The presence of substantial heterogeneity was assessed. If the P value was >0.1, the test of homogeneity was statistically significant, and then the fixed effects model was adopted. On the other hand, the random effects model was adopted if there was heterogeneity. Mean difference (MD) or relative risk (RR) and 95% confidence intervals (CIs) were used to analyze the end indices. A two-sided P value <0.05 was considered to indicate statistical significance.

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