Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Systematic Review”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,009 records · Page 56Linked to original sources
PubMedDate not supplied

Tonic-clonic seizures: a systematic review of antiepilepsy drug efficacy and safety.

This systematic review of studies of patients with generalized tonic-clonic seizures is an effort to evaluate whether one therapeutic agent is superior to another in terms of reducing seizures and tolerability. Recognizing that assessing relative efficacy is dependent on controlling the specific type of seizure or epilepsy treated, we restricted our review to studies in which the seizure types were clearly identified. Overall, complete control of generalized tonic-clonic seizures was achieved in 53% of treated patients. The percentage of patients who became seizure free was not significantly different with carbamazepine, phenytoin, or valproate. When patients who had a partial onset of their generalized tonic-clonic seizures were grouped, complete control was achieved in 48% with carbamazepine, 49% with phenytoin, and 52% with valproate. Overall, carbamazepine, phenytoin, and valproate appear to have similar efficacy in the treatment of tonic-clonic seizures, with complete control reported in 51%, 50%, and 55% of patients, respectively. The best response in primary generalized seizures was with valproate, with 61% reported as seizure free. Acute and dose-related central nervous system side effects occurred with equal frequency with carbamazepine, phenytoin, and valproate treatment. These side effects diminished after chronic exposure. Overall, 9.9% of patients discontinued treatment due to adverse effects. The lowest incidences of clinically important side effects and rash were reported in patients treated with valproate.

Anticonvulsants↗
PubMed2006

Young people and physical activity: a systematic review matching their views to effective interventions.

A systematic review was conducted to examine the barriers to, and facilitators of, physical activity among young people (11-16 years). The review focused on the wider determinants of health, examining community- and society-level interventions. Four trials and 16 studies of young people's views were included. Evidence for the effectiveness of the interventions was limited, with some suggestions of improvements in knowledge and possible differences according to gender. Young women in particular identified barriers to physical activity associated with certain ways of providing physical education in schools. Young people in general identified a need for increased choice and facilities within the community and emphasized physical activity's social side. Some of the barriers and facilitators identified by young people had been addressed by 'soundly evaluated' effective interventions but significant gaps were identified where no evaluated interventions appear to have been published (e.g. initiatives explicitly addressing gender issues or the combination of sport and other leisure activities), or where there were no soundly evaluated interventions. Rigorous evaluation is required particularly to assess initiatives that address the limited practical and material resources that young people identify as barriers to physical activity.

Adolescent↗
PubMed2004

Spinal cord stimulation for patients with failed back surgery syndrome or complex regional pain syndrome: a systematic review of effectiveness and complications.

We conducted a systematic review of the literature on the effectiveness of spinal cord stimulation (SCS) in relieving pain and improving functioning for patients with failed back surgery syndrome and complex regional pain syndrome (CRPS). We also reviewed SCS complications. Literature searches yielded 583 articles, of which seven met the inclusion criteria for the review of SCS effectiveness, and 15 others met the criteria only for the review of SCS complications. Two authors independently extracted data from each article, and then resolved discrepancies by discussion. We identified only one randomized trial, which found that physical therapy (PT) plus SCS, compared with PT alone, had a statistically significant but clinically modest effect at 6 and 12 months in relieving pain among patients with CRPS. Similarly, six other studies of much lower methodological quality suggest mild to moderate improvement in pain with SCS. Pain relief with SCS appears to decrease over time. The one randomized trial suggested no benefits of SCS in improving patient functioning. Although life-threatening complications with SCS are rare, other adverse events are frequent. On average, 34% of patients who received a stimulator had an adverse occurrence. We conclude with suggestions for methodologically stronger studies to provide more definitive data regarding the effectiveness of SCS in relieving pain and improving functioning, short- and long-term, among patients with chronic pain syndromes.

Back Pain↗
PubMed2006

Periodontal infection and adverse pregnancy outcomes: a systematic review of epidemiological studies.

The objective of this systematic review was to evaluate analytical studies on periodontal disease as a possible risk factor for adverse pregnancy outcomes. A literature search of the MEDLINE, SciELO, and LILACS bibliographic databases and CAPES thesis database was conducted up to December 2005, covering epidemiological studies of periodontal disease and adverse pregnancy outcomes. Of the 964 papers identified, 36 analytical studies met the inclusion criteria. Twenty-six epidemiological studies reported associations between periodontal disease and adverse pregnancy outcomes. There was a clear heterogeneity between studies concerning measurement of periodontal disease and selection of type of adverse pregnancy outcome. Therefore no meta-analysis was performed. Most studies did not control for confounders, thus raising serious doubts about their conclusions. The methodological limitations of most studies did not allow conclusions concerning the effects of periodontal disease on adverse pregnancy outcomes. Larger and methodologically rigorous analytical studies using reliable outcomes and exposure measures are recommended.

Brazil↗
PubMed2000

The role of size at birth and postnatal catch-up growth in determining systolic blood pressure: a systematic review of the literature.

OBJECTIVE: To conduct a systematic review in order to (i) summarize the relationship between birthweight and blood pressure, following numerous publications in the last 3 years, (ii) assess whether other measures of size at birth are related to blood pressure, and (iii) study the role of postnatal catch-up growth in predicting blood pressure. DATA IDENTIFICATION: All papers published between March 1996 and March 2000 that examined the relationship between birth weight and systolic blood pressure were identified and combined with the papers examined in a previous review. SUBJECTS: More than 444,000 male and female subjects aged 0-84 years of all ages and races. RESULTS: Eighty studies described the relationship of blood pressure with birth weight The majority of the studies in children, adolescents and adults reported that blood pressure fell with increasing birth weight, the size of the effect being approximately 2 mmHg/kg. Head circumference was the only other birth measurement to be most consistently associated with blood pressure, the magnitude of the association being a decrease in blood pressure by approximately 0.5 mmHg/cm. Skeletal and non-skeletal postnatal catch-up growth were positively associated with blood pressure, with the highest blood pressures occurring in individuals of low birth weight but high rates of growth subsequently. CONCLUSIONS: Both birth weight and head circumference at birth are inversely related to systolic blood pressure. The relationship is present in adolescence but attenuated compared to both the pre- and post-adolescence periods. Accelerated postnatal growth is also associated with raised blood pressure.

Adolescent↗
PubMed2005

Young people and healthy eating: a systematic review of research on barriers and facilitators.

A systematic review was conducted to examine the barriers to, and facilitators of, healthy eating among young people (11-16 years). The review focused on the wider determinants of health, examining community- and society-level interventions. Seven outcome evaluations and eight studies of young people's views were included. The effectiveness of the interventions was mixed, with improvements in knowledge and increases in healthy eating but differences according to gender. Barriers to healthy eating included poor school meal provision and ease of access to, relative cheapness of and personal taste preferences for fast food. Facilitators included support from family, wider availability of healthy foods, desire to look after one's appearance and will-power. Friends and teachers were generally not a common source of information. Some of the barriers and facilitators identified by young people had been addressed by soundly evaluated effective interventions, but significant gaps were identified where no evaluated interventions appear to have been published (e.g. better labelling of food products), or where there were no methodologically sound evaluations. Rigorous evaluation is required particularly to assess the effectiveness of increasing the availability of affordable healthy food in the public and private spaces occupied by young people.

Adolescent↗
PubMed2000

Effect of postmenopausal hormone replacement therapy on dental outcomes: systematic review of the literature and pharmacoeconomic analysis.

A systematic review and economic analysis of clinical trials evaluating the effect of hormone replacement therapy (HRT) on dental outcomes in postmenopausal women were conducted. Twenty published studies involving more than 13,735 postmenopausal women were summarized and analyzed. In prospective studies, the effect of HRT on osteoporosis (OP) has been well documented. The effect of OP on mandibular bone density has also been examined in some observational studies. Few studies, however, have examined the effect of HRT directly on mandibular bone density or on dental outcomes. From these studies, the effect of HRT on costs of dental treatment and prophylaxis was estimated directly and indirectly. It was determined that HRT use was associated with reduction in adverse dental outcomes and the associated costs of dental care. Annualized excess cost in a cohort of 1,000 untreated women averaged $100,000. From this analysis, it is clear that postmenopausal women with OP who do not receive HRT have a greater incidence of adverse dental outcomes and higher dental care costs than those who do.

Aged↗
PubMed2004

Risk factors for dental caries in young children: a systematic review of the literature.

OBJECTIVE: To conduct a systematic review of the literature on risk factors for dental caries in deciduous teeth of children aged six years and under, to give a scientific framework for the international collaborative studies on inequalities in childhood caries. METHOD: Accepted guidelines were followed. Studies were identified by electronic searching and reviewed on the basis of key words, title and abstract by two reviewers to assess whether inclusion criteria were met. Copies of all articles were obtained and assessed for quality according to the study design. RESULTS: 1029 papers were identified from the electronic search, 260 met the prima facie inclusion criteria. 183 were excluded once full copies of these papers were obtained. Of the 77 studies included, 43 were cross sectional, 19 cohort studies, 8 case control studies and 7 interventional studies. Few obtained the highest quality scores. 106 risk factors were significantly related to the prevalence or incidence of caries. CONCLUSION: There is a shortage of high quality studies using the optimum study design, i.e. a longitudinal study. The evidence suggests that children are most likely to develop caries if Streptococcus Muttans is acquired at an early age, although this may be partly compensated by other factors such as good oral hygiene and a non-cariogenic diet. Diet and oral hygiene may interact so that if there is a balance of 'good' habits by way of maintaining good plaque control and 'bad' habits by way of having a cariogenic diet, the development of caries may be controlled.

Child↗
PubMedDate not supplied

Anthocyanosides of Vaccinium myrtillus (bilberry) for night vision--a systematic review of placebo-controlled trials.

We have systematically reviewed placebo-controlled trials of V. myrtillus-extracted anthocyanosides for evidence of positive effects on night vision. Searches of computerized databases and citations in retrieved articles identified 30 trials with outcome measures relevant to vision in reduced light. Of these, 12 were placebo-controlled. The 4 most recent trials were all randomized controlled trials (RCTs) and were negative in outcome. A fifth RCT and 7 non-randomized controlled trials reported positive effects on outcome measures relevant to night vision. Negative outcome was associated with more rigorous methodology but also with lower dose level and extracts from geographically distinct sources that may differ in anthocyanoside composition. Healthy subjects with normal or above average eyesight were tested in 11 of the 12 trials. The hypothesis that V. myrtillus anthocyanosides improves normal night vision is not supported by evidence from rigorous clinical studies. There is a complete absence of rigorous research into the effects of the extract on subjects suffering impaired night vision due to pathological eye conditions. Evidence from methodologically weaker trials and auxiliary evidence from animal studies, trials of synthetic anthocyanosides, and a recent randomized controlled trial of Ribes nigrum (black currant) anthocyanosides may warrant further trials of V. myrtillus anthocyanosides in subjects with impaired night vision.

Anthocyanins↗
PubMed2007

Coping in sport: A systematic review.

The aim of this paper was to systematically review the literature on coping in sport, examining evidence for both the trait and process perspectives, the types of coping strategies used by athletes, gender differences, age-related differences, and coping effectiveness. A comprehensive literature search of SPORTdiscus, PsychLIT, and PsychINFO in November 2004 yielded 64 studies spanning 16 years (1988 - 2004). The results indicated that athletes use a variety of coping strategies. Forty-six papers supported or adopted the process perspective (Lazarus, 1999; Lazarus & Folkman, 1984). There were also gender and age-related differences. Evidence was found to support three of the different models of coping effectiveness (goodness-of-fit approach, choice of coping strategy, and automacity). Based on this evidence, future research should address some of the methodological and measurement limitations of the sport psychology coping literature. In particular, prospective research designs that minimize the time delay between recall and the stressful experience are required to assess how coping changes over time. More attention to developmental issues to guide the formulation of sport-specific models to enhance our theoretical understanding is also required. Finally, coping effectiveness should be examined both in the short and long term, as a greater understanding of coping effectiveness has the potential to make a significant impact on applied practice.

Adaptation, Psychological↗
PubMed2025

Exercise Therapy in Down Syndrome: A Systematic Review and Meta-Analysis Focused on Muscle Strength, Redox Balance, and Inflammatory Profile.

OBJECTIVE: This study systematically reviewed and meta-analyzed randomized and quasi-randomized controlled trials investigating the impact of exercise therapy on muscle strength, redox balance, and inflammatory profile in individuals with Down syndrome. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, SPORTDiscus, EMBASE, and PEDro. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomized and quasi-randomized controlled trials exploring exercise therapy effects on muscle strength and redox balance in individuals with Down syndrome. Although no initial restrictions on age, gender, or health condition were applied during the search process, all included studies focused on adult participants (>18 yr old). No language restrictions were applied, and the search covered the period from 1970 to 2021. RESULTS: We assessed the abstract of 1964 studies. Of the 46 studies meeting the inclusion criteria for the period 2004-2021, 32 focused on muscle strength, and 14 examined redox balance and inflammation. A total of 1611 participants with a mean age of 27 yr were included. This review confirmed that different exercise modalities are prone to improve muscle strength (random effect (95% confidence interval): 0.66, 0.54 to 0.78), redox balance and inflammatory profile (random effect (95% confidence interval): -1.04, -1.31 to -0.76) in this population. The multimodel inference suggested that the frequency of training (times per week) might play a significant role in the main effect. Unsupervised machine learning algorithms displayed a pattern-based graphic representation to assess heterogeneity. CONCLUSIONS: Exercise training demonstrated a positive impact on muscle strength in adults with Down syndrome. The review provides valuable insights into the effects of exercise therapy on individuals with Down syndrome, emphasizing the need for tailored training prescriptions.

Humans↗
PubMed2003

Validation methodology in publications describing epidemiological registration methods of dental caries: a systematic review.

OBJECTIVE: The aim was to describe and systematically review the methodology and reporting of validation in publications describing epidemiological registration methods for dental caries. BASIC RESEARCH METHODOLOGY: Literature searches were conducted in six scientific databases. All publications fulfilling the predetermined inclusion criteria were assessed for methodology and reporting of validation using a checklist including items described previously as well as new items. The frequency of endorsement of the assessed items was analysed. Moreover, the type and strength of evidence, was evaluated. MAIN OUTCOME MEASURES: Reporting of predetermined items relating to methodology of validation and the frequency of endorsement of the assessed items were of primary interest. RESULTS: Initially 588 publications were located. 74 eligible publications were obtained, 23 of which fulfilled the inclusion criteria and remained throughout the analyses. A majority of the studies reported the methodology of validation. The reported methodology of validation was generally inadequate, according to the recommendations of evidence-based medicine. The frequencies of reporting the assessed items (frequencies of endorsement) ranged from four to 84 per cent. A majority of the publications contributed to a low strength of evidence. CONCLUSION: There seems to be a need to improve the methodology and the reporting of validation in publications describing professionally registered caries epidemiology. Four of the items assessed in this study are potentially discriminative for quality assessments of reported validation.

Dental Caries↗
PubMed2026

Apolipoprotein E Alleles Across the Spectrum of Frontotemporal Lobar Degeneration: A Systematic Review and Meta-Analysis.

We conducted a systematic review and meta-analysis of associations between apolipoprotein E (APOE) alleles and frontotemporal lobar degeneration (FTLD)-spectrum disorders. MEDLINE, Embase, CENTRAL, and Google Scholar were searched. APOE2 and APOE4 carrier status were compared between FTLD-spectrum disorders and healthy controls (HCs) or individuals with Alzheimer's disease (AD). Forty studies were included. APOE4 carriage was more frequent in frontotemporal dementia (FTD) compared with HC (OR = 1.72; 95% CI = 1.45-2.04) and less common than in AD (OR = 0.35; 95% CI = 0.29-0.42). In contrast, APOE2 carriage was less prevalent in FTD relative to HC (OR = 0.83; 95% CI = 0.70-0.98) but more frequent compared with AD (OR = 1.80; 95% CI = 1.29-2.52). APOE4 effects were most pronounced in behavioral variant FTD. In clinically confirmed progressive supranuclear palsy (PSP), APOE4 carriage was not associated with PSP. Analysis restricted to pathologically confirmed PSP cases, however, showed lower APOE4 carriage in PSP than in healthy controls (OR = 0.78, 95% CI = 0.65-0.94), although this association failed to reach the multiplicity-adjusted significance threshold. APOE2 carriage was not associated with PSP in either clinically established or pathologically confirmed samples. Evidence was insufficient to establish or exclude associations for other FTLD-spectrum disorders because of the limited available data. In conclusion, APOE alleles show distinct associations across the FTLD spectrum.

Humans↗
PubMed2004

Interventions for treating collagenous colitis: a Cochrane Inflammatory Bowel Disease Group systematic review of randomized trials.

OBJECTIVES: To conduct a systematic review to determine effective treatments for patients with clinically active collagenous colitis. METHODS: Relevant articles were identified via the MEDLINE, PUBMED, and Cochrane Collaboration databases, manual searches of the references of identified articles, and review articles on collagenous or microscopic colitis, as well as searches of abstracts from major gastroenterological meetings. RESULTS: Five randomized trials assessing treatments for collagenous colitis were identified. One trial studying bismuth subsalicylate (nine 262 mg tablets daily for 8 wk) included 9 patients. Patients who received the bismuth preparation were more likely to have clinical (p= 0.003) and histological (p= 0.003) improvement than those who received placebo. In a trial comparing prednisolone (50 mg daily for 2 wk) to a placebo in 11 patients, a trend toward clinical response in patients on prednisone was reported (p= 0.064). The effect of prednisolone on histological improvement was not studied. A total of 94 patients were enrolled in three trials studying budesonide (9 mg daily or in a tapering schedule for 6-8 wk). The pooled odds ratio for clinical response to treatment with budesonide was 12.32 (95% CI: 5.53-27.46). The NNT (number of patients needed to treat with budesonide to achieve 1 improved patient) was 2 patients. This therapy was well tolerated. There was significant histological improvement with treatment in all three trials studying budesonide therapy. CONCLUSIONS: There is strong evidence that budesonide is effective and well tolerated for the treatment of collagenous colitis. The evidence for benefit with bismuth subsalicylate or prednisolone is weaker. It is not clear that any of these agents produce actual remission, as opposed to clinical and histological improvement of the disease.

Anti-Inflammatory Agents↗
PubMed2006

Segmental stabilizing exercises and low back pain. What is the evidence? A systematic review of randomized controlled trials.

STUDY DESIGN: A systematic review of randomized controlled trials. OBJECTIVES: To evaluate the effectiveness of segmental stabilizing exercises for acute, subacute and chronic low back pain with regard to pain, recurrence of pain, disability and return to work. METHODS: MEDLINE, EMBASE, CINAHL, Cochrane Controlled Trials Register, PEDro and article reference lists were searched from 1988 onward. Randomized controlled trials with segmental stabilizing exercises for adult low back pain patients were included. Four comparisons were foreseen: (1) effectiveness of segmental stabilizing exercises versus treatment by general practitioner (GP); (2) effectiveness of segmental stabilizing exercises versus other physiotherapy treatment; (3) effectiveness of segmental stabilizing exercises combined with other physiotherapy treatment versus treatment by GP and (4) effectiveness of segmental stabilizing exercises combined with other physiotherapy treatment versus other physiotherapy treatment. RESULTS: Seven trials were included. For acute low back pain, segmental stabilizing exercises are equally effective in reducing short-term disability and pain and more effective in reducing long-term recurrence of low back pain than treatment by GP. For chronic low back pain, segmental stabilizing exercises are, in the short and long-term, more effective than GP treatment and may be as effective as other physiotherapy treatments in reducing disability and pain. There is limited evidence that segmental stabilizing exercises additional to other physiotherapy treatment are equally effective for pain and more effective concerning disability than other physiotherapy treatments alone. There is no evidence concerning subacute low back pain. CONCLUSION: For low back pain, segmental stabilizing exercises are more effective than treatment by GP but they are not more effective than other physiotherapy interventions.

Acute Disease↗
PubMedDate not supplied

Value of maintenance therapy with oral tocolytics: a systematic review.

OBJECTIVE: The objective was to perform a systematic review of prospective randomized trials evaluating the efficacy of oral tocolytics in the prevention of recurrent preterm labor and its associated complications. METHODS: A MEDLINE search of English language articles published since 1966 was performed to identify studies of maintenance oral tocolytic therapy. Studies were included in the review which: 1) randomized patients to an oral tocolytic after stabilization with parenteral therapy; 2) reported results for either a placebo or a control group; and 3) included patients with intact membranes only. These studies were analyzed for nine outcomes, including incidence of preterm delivery, incidence of recurrent preterm labor, latency from treatment to delivery, gestational age, birthweight, admission to an intensive care nursery (ICN), incidence of respiratory distress syndrome (RDS), incidence of intraventricular hemorrhage (IVH), and perinatal mortality. RESULTS: Seven studies met the inclusion criteria, four of which used oral terbutaline for the treatment arm (two had a control group, and two had a placebo group), and one used oral ritodrine (with a placebo group). Of the remaining two, one used oral ritodrine and oral magnesium chloride (with a control group), and the other used oral terbutaline and oral magnesium chloride (with a placebo group). The results of the individual studies suggest that there was no beneficial effect of oral tocolytic therapy on the incidence of preterm delivery (odds ratio (OR) range: 0.7-2.0), incidence of preterm labor recurrence (OR range: 0.6-3.2), ICN admission (OR range: 1.3-2.0), incidence of RDS (OR range 0.1-4.3), incidence of IVH (OR range 0.3-2.0), perinatal mortality (OR range: 1.6-4.3), or gestational age at delivery. CONCLUSIONS: We concluded that a meta-analysis based on the available studies is not possible due to the fact that there is little that these seven studies have in common with respect to treatment comparisons. In addition, inconsistent definitions of outcome variables makes pooling this data inappropriate and invalid. Therefore, well-designed, large, randomized trials are needed to evaluate the efficacy of oral tocolytics in improving perinatal outcome.

Administration, Oral↗
PubMed2002

Tamsulosin for treating lower urinary tract symptoms compatible with benign prostatic obstruction: a systematic review of efficacy and adverse effects.

PURPOSE: We systematically reviewed the effectiveness and adverse effects of tamsulosin for lower urinary tract symptoms compatible with benign prostatic obstruction. MATERIALS AND METHODS: Studies were included in analysis when they involved a randomized 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 standard forms using a prospective 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.

Humans↗
PubMed2002

Terazosin for treating symptomatic benign prostatic obstruction: a systematic review of efficacy and adverse effects.

OBJECTIVE: To systematically review and evaluate the effectiveness and adverse effects of the alpha-antagonist, terazosin, for treating urinary symptoms associated with benign prostatic obstruction (BPO). METHODS: Studies were sought and included in the review if they were randomized trials of at least 1 month duration, involved men with symptomatic BPO and compared terazosin with placebo or active controls. The study, patient characteristics and outcome data were extracted in duplicate onto standardized forms using a prospectively developed protocol. RESULTS: Seventeen studies involving 5151 men met the inclusion criteria, i.e. placebo-controlled (10), alpha-blockers (seven), finasteride alone or combined with terazosin and placebo (one), and microwave therapy (one). The study duration was 4-52 weeks; the mean age of the men was 65 years and 82% were white. Baseline urological symptom scale scores and flow rates showed that men had moderate BPO. Efficacy outcomes were rarely reported in a way that allowed for data pooling, but indicated that terazosin improved symptom scores and flow rates more than did placebo or finasteride, and similarly to other alpha-antagonists. The pooled mean percentage improvement for the Boyarsky symptom score was 37% for terazosin and 15% for placebo (four studies). The mean percentage improvement for the American Urological Association symptom score was 38%, compared with 17% and 20% for placebo and finasteride, respectively (two studies). The pooled mean improvement in the International Prostate Symptom Score of 40% was similar to that with tamsulosin (43%). Peak urinary flow rates improved more with terazosin (22%) than with placebo (11%) and finasteride (15%), but did not differ significantly from the other alpha-antagonists. The percentage of men discontinuing terazosin was comparable with those receiving placebo and finasteride, but greater than with other alpha-antagonists. Adverse effects were greater than with placebo and included dizziness, asthenia, headache and postural hypotension. CONCLUSIONS: The available evidence indicates that terazosin improves the symptoms and flow rates associated with BPO; it was more effective than placebo or finasteride and similar to other alpha-antagonists. Adverse effects were generally mild but more frequent than with other alpha-antagonists and associated with a two- to four-fold increase in treatment discontinuation.

Adrenergic alpha-Antagonists↗