J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://jocmr.elmerjournals.com

Review

Volume 16, Number 9, September 2024, pages 385-397

Tamsulosin and Dutasteride Combination Therapy for Asian Men With Moderate-to-Severe Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: A Systematic Review of Clinical Considerations That Influence the Prescription

Figure 1. PRSMA flow diagram. PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses. IPSS: international prostate symptom score; CASP: Critical Appraisal Skills Program; UTI: urinary tract infection; RCT: randomized controlled trial.

**Table 1.** Selection Criteria
Inclusion criteria	Exclusion criteria
LUTS/BPH: lower urinary tract symptoms secondary to benign prostatic hyperplasia; IPSS: international prostate symptom score; RCTs: randomized controlled trials; UTI: urinary tract infection.
Asian men who aged 45 years and above	Other non-tamsulosin + dutasteride combination therapy and either monotherapy
Moderate-to-severe LUTS/BPH	Diagnosed with other prostate condition simultaneously (prostatitis, prostate cancer, UTI) and other conditions that may lead to dysuria (neurogenic bladder, urethral stricture, etc.)
Diagnosed BPH with IPSS ≥ 8	History of any current or prior relevant BPH treatments
Tamsulosin + dutasteride combination therapy treatment and either tamsulosin or dutasteride monotherapy	Non-English language studies
Long-term intervention for at least 1 year
RCTs that conducted ≤ 12 years ago

Table 1. Selection Criteria

Inclusion criteria

Exclusion criteria

LUTS/BPH: lower urinary tract symptoms secondary to benign prostatic hyperplasia; IPSS: international prostate symptom score; RCTs: randomized controlled trials; UTI: urinary tract infection.

Asian men who aged 45 years and above

Other non-tamsulosin + dutasteride combination therapy and either monotherapy

Moderate-to-severe LUTS/BPH

Diagnosed with other prostate condition simultaneously (prostatitis, prostate cancer, UTI) and other conditions that may lead to dysuria (neurogenic bladder, urethral stricture, etc.)

Diagnosed BPH with IPSS ≥ 8

History of any current or prior relevant BPH treatments

Tamsulosin + dutasteride combination therapy treatment and either tamsulosin or dutasteride monotherapy

Non-English language studies

Long-term intervention for at least 1 year

RCTs that conducted ≤ 12 years ago

**Table 2.** Quality Assessment of RCTs Using CASP Checklist
Authors, year	Q1	Q2	Q3	Q4	Q5	Q6	Q7	Q8	Q9	Q10	Q11	TS
RCTs: randomized controlled trials; Q: question; CASP: Critical Appraisal Skills Program; Y: yes; N: no; CT: cannot tell; TS: total score.
Lee et al, 2012, [58]	Y	Y	N	N	Y	Y	N	CT	N	CT	CT	4
Chung et al, 2012 [64]	Y	Y	Y	Y	Y	Y	Y	CT	N	CT	Y	8
Roehrborn et al, 2014, [65]	Y	Y	Y	Y	Y	Y	Y	Y	N	Y	Y	10
Roehrborn et al, 2015, [66]	Y	Y	Y	N	Y	Y	Y	Y	N	CT	Y	8
Chung et al, 2018 [67]	Y	Y	Y	Y	Y	Y	Y	Y	N	Y	Y	10
Haque et al, 2018 [68]	Y	Y	Y	Y	Y	Y	Y	CT	N	Y	Y	9
Ngu et al, 2022 [59]	Y	Y	Y	N	Y	Y	N	CT	N	CT	CT	5

Table 2. Quality Assessment of RCTs Using CASP Checklist

Authors, year

Q10

Q11

RCTs: randomized controlled trials; Q: question; CASP: Critical Appraisal Skills Program; Y: yes; N: no; CT: cannot tell; TS: total score.

Lee et al, 2012, [58]

Chung et al, 2012 [64]

Roehrborn et al, 2014, [65]

Roehrborn et al, 2015, [66]

Chung et al, 2018 [67]

Haque et al, 2018 [68]

Ngu et al, 2022 [59]