Based on improvement of mean International Prostate Symptom Score and quality of life scores , the effectiveness of the newer ABs was not different from the older ABs ( moderate strength of evidence [ SOE ] ) , but had more AEs ( low SOE ) .
Antimuscarinics/AB combination therapy had similar outcomes  as AB monotherapy ( all moderate SOE ) , but often had more AEs .
Phosphodiesterase type-5 inhibitors alone or in combination with ABs had similar or inferior outcomes than ABs alone .
Evidence was insufficient for the beta-3 adrenoceptor agonist .
For all newer agents , the evidence was generally insufficient to assess long-term efficacy , prevention of symptom progression , or AEs .
None of the drugs or drug combinations newly used to treat LUTS attributed to BPH showed outcomes superior to traditional AB treatment .
Given the lack of superior outcomes , the studies ' short time-horizon , and less assurance of their safety , their current value in treating LUTS attributable to BPH appears low .
We found none of the new drugs to be better but there was more concern about side effects
CONTEXT Alpha-blockers ( ABs ) and 5-alpha reductase inhibitors have an established role in treating male lower urinary tract symptoms ( LUTS ) attributed to benign prostatic hyperplasia ( BPH ) .
Recently , newer drugs have shown promise for this indication .
OBJECTIVE To assess the comparative effectiveness and adverse effects ( AEs ) of newer drugs to treat LUTS attributed to BPH through a systematic review and meta- analysis .
PATIENT SUMMARY In this paper , we review ed the evidence of newer drugs to treat men with urinary problems attributable to an enlarged prostate .
Comparison of Two Different α1-Adrenoceptor Antagonists, Tamsulosin and Silodosin, in the Treatment of Male Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia: A Prospective Randomized Crossover Study.
OBJECTIVES We assessed the efficacy and safety of two α1-adrenoceptor antagonists , tamsulosin and silodosin , in the treatment of male lower urinary tract symptoms . METHODS Men aged 50 years or older who had a total International Prostate Symptom Score ( IPSS ) of 8 or higher were enrolled in this study . Forty-six patients were r and omized into two groups . Twenty-three patients were initially prescribed tamsulosin 0.2 mg once daily for 3 months , followed by silodosin 4 mg twice daily for 3 months ( group T ) ; the other group of 23 patients were initially prescribed silodosin , followed by tamsulosin ( group S ) . Patients then switched to the alternative treatment after a 1-month clearance period . Evaluations included clinical determination of IPSS , quality -of-life index , maximum flow rate and postvoid residual urine volume before and after treatment . RESULTS A total of 46 men , 23 in group T and 23 in group S , were treated and 41 ( 89.1 % ) completed the treatment . IPSS , quality -of-life index , maximum flow rate and postvoid residual urine volume were significantly improved in both groups after treatment . The changes in the total IPSS from baseline in groups S and T at 3 months were -6.6 and -7.5 , respectively . There were no significant differences between the two groups . After taking both medications , 18 patients preferred silodosin , 11 preferred tamsulosin and others felt they had the same effects . Six and none patients experienced adverse events  during silodosin and tamsulosin treatment , respectively . CONCLUSION Two types of α1-adrenoceptor antagonists in the same individuals provide similar efficacy . Profiles and difference of each drug should be considered in making treatment choice
Based on improvement of mean International Prostate Symptom Score and quality of life scores , the effectiveness of the newer ABs was not different from the older ABs ( moderate strength of evidence [ SOE ] ) , but had more AEs ( low SOE ) .
Antimuscarinics/AB combination therapy had similar outcomes  as AB monotherapy ( all moderate SOE ) , but often had more AEs .
Phosphodiesterase type-5 inhibitors alone or in combination with ABs had similar or inferior outcomes than ABs alone .
Evidence was insufficient for the beta-3 adrenoceptor agonist .
For all newer agents , the evidence was generally insufficient to assess long-term efficacy , prevention of symptom progression , or AEs .
None of the drugs or drug combinations newly used to treat LUTS attributed to BPH showed outcomes superior to traditional AB treatment .
Given the lack of superior outcomes , the studies ' short time-horizon , and less assurance of their safety , their current value in treating LUTS attributable to BPH appears low .
We found none of the new drugs to be better but there was more concern about side effects
CONTEXT Alpha-blockers ( ABs ) and 5-alpha reductase inhibitors have an established role in treating male lower urinary tract symptoms ( LUTS ) attributed to benign prostatic hyperplasia ( BPH ) .
Recently , newer drugs have shown promise for this indication .
OBJECTIVE To assess the comparative effectiveness and adverse effects ( AEs ) of newer drugs to treat LUTS attributed to BPH through a systematic review and meta- analysis .
PATIENT SUMMARY In this paper , we review ed the evidence of newer drugs to treat men with urinary problems attributable to an enlarged prostate .