Evidence-based meta-analysis of pharmacotherapy for benign prostatic hypertrophy

Evidence-based diagnosis and treatment have been proposed recently in various medical fields. Evidence-based diagnostic and therapeutic guidelines for benign prostatic hypertrophy (BPH), one of the most common urological diseases, have been proposed in foreign countries. This paper examines common therapeutic drugs for BPH in Japan from the viewpoint of evidence-based medicine (EBM). The term 'BPH' and drugs indicated for BPH were used as key words to search related articles in the PubMed website. A total of 813 articles extracted as of October 2001 were examined. The articles were ranked in levels ranging from I-V, where Level I indicated a large randomized controlled trial and Level V indicated a non-controlled case accumulation study. Among the 813 articles extracted, 132 clinical articles were suitable for evaluation. There were many reliable articles on the effectiveness of alpha-blockers. However, it seemed necessary to examine further how to choose the optimum alpha-blocker for each clinical case and the combination of antiandrogen drugs with alpha-blockers. It was also considered necessary to evaluate the effectiveness of drugs, such as eviprostat and hachimi-jio-gan, that are available only in Japan. The present study evaluated the effectiveness of commonly available therapeutic drugs for BPH in Japan from a viewpoint of EBM.