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Tang G, Liu M, Ding G, Liu S, Chu Y, Cui Y, Wu J. The Efficacy of Cyclooxygenase-2 Inhibitors for the Male Treatment of Lower Urinary Tract Symptoms: A Systematic Review and Meta-Analysis. Am J Mens Health 2023; 17:15579883231176667. [PMID: 37249083 PMCID: PMC10236251 DOI: 10.1177/15579883231176667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/07/2023] [Accepted: 05/01/2023] [Indexed: 05/31/2023] Open
Abstract
To investigate the potential use of cyclooxygenase-2 (COX-2) inhibitors in the treatment of lower urinary tract symptoms (LUTS) in male patients, we conducted a comprehensive meta-analysis. Our study involved the identification and collection of randomized controlled trials (RCTs) from leading databases including PubMed, MEDLINE, EMBASE, and Cochrane Library. The primary objective of this analysis was to evaluate the effectiveness of COX-2 inhibitors for the treatment of LUTS. Our analysis involved six short-term (within 3 months) RCTs involving 707 patients. We found that COX-2 inhibitor treatment significantly improved the International Prostate Symptom Score (IPSS) of patients (mean difference [MD] = -2.99, 95% confidence interval (CI): -3.65 to -2.33, p < .00001), nocturia frequency (MD = -1.90; 95% CI: -3.18 to -0.61, p = .004), and maximum flow rate (Qmax) (MD = 1.02; 95% CI: 0.06 to 1.98, p = .04). However, no significant differences were found between patients in terms of changes in prostate-specific antigen (PSA) (MD = 0.02; 95% CI: -0.39 to 0.43, p = .92) and total prostate volume (TPV) (MD = -2.93; 95% CI: -6.45 to 0.59, p = .10). Therefore COX-2 inhibitors are an effective treatment for LUTS.
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Affiliation(s)
- Gonglin Tang
- Department of Urology, The Affiliated
Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Ming Liu
- Department of Urology, The Affiliated
Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
- Second Clinical Medical College,
Binzhou Medical University, Yantai, China
| | - Guixin Ding
- Department of Urology, The Affiliated
Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Shangjing Liu
- Department of Urology, The Affiliated
Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Yongli Chu
- Department of Scientific Research, The
Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Yuanshan Cui
- Department of Urology, The Affiliated
Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Jitao Wu
- Department of Urology, The Affiliated
Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
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Yao HHI, Crump RT, Charbonneau C, Khan A, Barton C, Brotherhood H, Jiang J, Carlson KV, Baverstock RJ. Baseline patient reported outcomes data shows high prevalence of overactive bladder, sexual dysfunction, depression and anxiety in Canadian men with newly diagnosed localized prostate cancer. Transl Androl Urol 2020; 9:2046-2053. [PMID: 33209668 PMCID: PMC7658156 DOI: 10.21037/tau-20-689] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background Research on prostate cancer survivorship patients has largely been on oncological outcome, incontinence and erectile dysfunction, with less data on the relationship between prostate cancer, bladder function and mental health. This study aims to elucidate the prevalence of lower urinary tract symptoms (LUTS), overactive bladder (OAB), sexual dysfunction, depression and anxiety in Canadian men with newly diagnosed localised prostate cancer. Methods This is a single-centre prospective cross-sectional study of men with newly diagnosed localized prostate cancer recruited from June 2017 to July 2018. The patient-reported outcomes (PRO) instruments used in this study included the international prostate symptoms score (IPSS), OAB-V8, EQ-5D™, and the Expanded Prostate Cancer Index Composite short form (EPIC-26). Clinico-pathological data were extracted from medical records. The prevalence of LUTS, OAB, sexual dysfunction, depression and anxiety were determined from the PROs. Results A total of 83 patients were included in this study. The median age was 63. Based on IPSS scores, 55.3% of men had mild LUTS, 36.8% had moderate LUTS and 7.9% had severe LUTS. Based on OAB-V8 scores, 55.8% of men had a score of 8 or higher, suggestive of OAB. Only 55.8% of men reported erections adequate for intercourse. 23.1% of men reported to have a moderate to big problem with depression, and 28.8% of men reported to have a degree of anxiety or depression. Conclusions OAB is a significant problem in men with newly diagnosed localized prostate cancer, with a prevalence of 55.8% based on this study. Baseline sexual dysfunction, anxiety and depression are also prevalent in this population.
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Affiliation(s)
- Henry Han-I Yao
- Vesia (Alberta Bladder Centre), Calgary, Alberta, Canada.,Department of Surgery, University of Calgary, Calgary, Alberta, Canada.,Eastern Health Clinical School, Monash University, Melbourne, Australia
| | | | | | - Asher Khan
- Vesia (Alberta Bladder Centre), Calgary, Alberta, Canada
| | - Carly Barton
- Vesia (Alberta Bladder Centre), Calgary, Alberta, Canada
| | - Hilary Brotherhood
- Vesia (Alberta Bladder Centre), Calgary, Alberta, Canada.,Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Jing Jiang
- Vesia (Alberta Bladder Centre), Calgary, Alberta, Canada
| | - Kevin V Carlson
- Vesia (Alberta Bladder Centre), Calgary, Alberta, Canada.,Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Richard J Baverstock
- Vesia (Alberta Bladder Centre), Calgary, Alberta, Canada.,Department of Surgery, University of Calgary, Calgary, Alberta, Canada
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Lyauk YK, Jonker DM, Lund TM, Hooker AC, Karlsson MO. Item Response Theory Modeling of the International Prostate Symptom Score in Patients with Lower Urinary Tract Symptoms Associated with Benign Prostatic Hyperplasia. AAPS JOURNAL 2020; 22:115. [PMID: 32856168 PMCID: PMC7452927 DOI: 10.1208/s12248-020-00500-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 08/12/2020] [Indexed: 11/30/2022]
Abstract
Item response theory (IRT) was used to characterize the time course of lower urinary tract symptoms due to benign prostatic hyperplasia (BPH-LUTS) measured by item-level International Prostate Symptom Scores (IPSS). The Fisher information content of IPSS items was determined and the power to detect a drug effect using the IRT approach was examined. Data from 403 patients with moderate-to-severe BPH-LUTS in a placebo-controlled phase II trial studying the effect of degarelix over 6 months were used for modeling. Three pharmacometric models were developed: a model for total IPSS, a unidimensional IRT model, and a bidimensional IRT model, the latter separating voiding and storage items. The population-level time course of BPH-LUTS in all models was described by initial improvement followed by worsening. In the unidimensional IRT model, the combined information content of IPSS voiding items represented 72% of the total information content, indicating that the voiding subscore may be more sensitive to changes in BPH-LUTS compared with the storage subscore. The pharmacometric models showed considerably higher power to detect a drug effect compared with a cross-sectional and while-on-treatment analysis of covariance, respectively. Compared with the sample size required to detect a drug effect at 80% power with the total IPSS model, a reduction of 5.9% and 11.7% was obtained with the unidimensional and bidimensional IPSS IRT model, respectively. Pharmacometric IRT analysis of the IPSS within BPH-LUTS may increase the precision and efficiency of treatment effect assessment, albeit to a more limited extent compared with applications in other therapeutic areas.
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Affiliation(s)
- Yassine Kamal Lyauk
- Translational Medicine, Ferring Pharmaceuticals A/S, Kay Fiskers Plads 11, 2300, Copenhagen, Denmark. .,Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark. .,Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden.
| | - Daniël M Jonker
- Translational Medicine, Ferring Pharmaceuticals A/S, Kay Fiskers Plads 11, 2300, Copenhagen, Denmark
| | - Trine Meldgaard Lund
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Andrew C Hooker
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Mats O Karlsson
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
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