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 .
Tamsulosin for treating lower urinary tract symptoms compatible with benign prostatic obstruction: a systematic review of efficacy and adverse effects.
PURPOSE We systematic ally review ed the effectiveness and adverse effects of tamsulosin for lower urinary tract symptoms compatible with benign prostatic obstruction . MATERIAL S AND METHODS Studies were included in analysis when they involved a r and omized trial of at least 1 month in duration , men with lower urinary tract symptoms and a comparison of tamsulosin with placebo or an active control . Study , patient and outcome data were extracted onto st and ard forms using a prospect i ve protocol . RESULTS Of the series 13 involving 3,418 men with a mean age of 64 years met our inclusion criteria . Study duration was 4 to 26 weeks . Baseline symptom scores and flow rates showed moderate lower urinary tract symptoms . Tamsulosin improved symptoms and peak urine flow compared with placebo . The weighted mean difference in the mean change from baseline for the Boyarsky symptom score for 0.4 and 0.8 mg . tamsulosin versus placebo was -1.1 ( 95 % confidence interval [ CI ] -1.49 to -0.72 or 12 % improvement ) and -1.6 points ( 95 % CI -2.3 to -1.0 or 16 % improvement ) , respectively . The weighted mean difference in the mean change from baseline in peak urine flow was 1.1 ( 95 % CI 0.59 to 1.51 ) and 1.1 ml . per second ( 95 % CI 0.65 to 1.48 ) for 0.4 and 0.8 mg . , respectively . The 0.2 to 0.4 mg . tamsulosin dose was as effective as other alpha-antagonists for improving symptoms and the flow rate , although the doses of all alpha-antagonists evaluated may not have been optimal . Treatment withdrawals and adverse effects increased markedly as the tamsulosin dose increased . CONCLUSIONS Tamsulosin improves lower urinary tract symptoms and flow . Its effectiveness was similar to that of other alpha-antagonists , increasing slightly at higher doses . Adverse effects were generally mild but the incidence , including treatment withdrawals , increased substantially at higher doses
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 .