Ther Adv Urol. 2021 Apr 12;13:1756287221993283. doi: 10.1177/1756287221993283. eCollection 2021.
Alfuzosin for the medical treatment of benign prostatic hyperplasia and lower urinary tract symptoms: a systematic review of the literature and narrative synthesis.
Therapeutic advances in urology
Andrea Mari, Alessandro Antonelli, Luca Cindolo, Ferdinando Fusco, Andrea Minervini, Cosimo De Nunzio
Affiliations
Affiliations
- Department of Urology, University of Florence, Careggi Hospital, San Luca Nuovo, Florence, Italy.
- Department of Urology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Italy.
- Department of Urology, Villa Stuart Private Hospital, Rome, Italy.
- Department of Woman, Child and General and Specialized Surgery University of Campania "Luigi Vanvitelli", Naples, Italy.
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi University Hospital, Florence, Italy.
- Division of Urology, Ospedale Sant'Andrea, Sapienza University of Rome, Rome, Italy.
PMID: 33912246
PMCID: PMC8047826 DOI: 10.1177/1756287221993283
Abstract
BACKGROUND: Lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) are a bothersome frequent symptom in adult males. This systematic review analyzed the available evidence on the pharmacokinetic and pharmacodynamic features of alfuzosin, and its clinical efficacy both as monotherapy and in combination with other drugs for the treatment of male LUTS/BPH.
METHODS: A systematic review of the last 10 years was performed using the MEDLINE, EMBASE and Cochrane libraries in March 2020. The protocol for this systematic review was registered on PROSPERO (Central Registration Depository: CRD42020136120) and is available in full on the University of York website.
RESULTS: Alfuzosin is a quinazoline derivative and, although a nonspecific α1-blocker, exhibits a selective concentration in the prostate compared with plasma in patients with BPH. Three registration trials assessed the safety and efficacy of alfuzosin. The 10 mg daily formulation has a three-layered matrix containing the active substance between two inactive coats allowing a drug release over 20 h. Alfuzosin showed high tolerability, few vasodilatory effects and a low rate of ejaculation disorders over older alpha-blocking compounds thanks to the high uroselectivity of alfuzosin and its preferential concentration at urinary level. Six randomized clinical trials (RCTs) assessed efficacy and safety of alfuzosin
CONCLUSIONS: Alfuzosin is an effective drug for the treatment of LUTS/BPH, with a lower rate of sexual disorders compared with other alpha-blockers. Alfuzosin is also safe with low adverse events in case of concomitant antihypertensive therapy and in patients with cardiovascular morbidity. Safety and efficacy of alfuzosin has been reported also in case of combination therapy with antimuscarinic agents and PDE5i.
© The Author(s), 2021.
Keywords: alfuzosin; alpha adrenoreceptor antagonists; benign prostatic hyperplasia; low urinary tract symptoms; pharmacology
Conflict of interest statement
Conflict of interest statement: Ferdinando Fusco: Speaker at symposiums and seminaries for Recordati, Astellas, Glaxo Smith Kline. Cosimo de Nunzio: Consultancy for Pierrefabre, Janssen, Sanofi, Glaxo
References
- Int J Impot Res. 2007 Sep-Oct;19(5):480-5 - PubMed
- BJU Int. 2000 Sep;86(4):432-8 - PubMed
- Circ Res. 1996 May;78(5):737-49 - PubMed
- Eur Urol. 2000 Feb;37(2):183-90 - PubMed
- Eur Urol. 2015 Jun;67(6):1099-1109 - PubMed
- J Sex Med. 2009 Feb;6(2):544-52 - PubMed
- BJU Int. 2005 Mar;95(4):603-8 - PubMed
- Urology. 2000 Nov 1;56(5 Suppl 1):20-2 - PubMed
- Ophthalmology. 2014 Apr;121(4):829-34 - PubMed
- Eur Urol. 2003 Dec;44(6):637-49 - PubMed
- BJU Int. 2003 Dec;92(9):1044; author reply 1044-5 - PubMed
- J Urol. 2014 Jan;191(1):130-7 - PubMed
- Br J Pharmacol. 1996 Nov;119(5):797-803 - PubMed
- Eur Urol. 2000 Mar;37(3):306-13 - PubMed
- Int J Impot Res. 2008 Dec;20 Suppl 3:S11-8 - PubMed
- Br J Pharmacol. 1993 Aug;109(4):1282-9 - PubMed
- Trans Am Ophthalmol Soc. 2009 Dec;107:234-9 - PubMed
- Eur Urol. 2000 Jun;37(6):680-6 - PubMed
- BJU Int. 2005 May;95(7):1006-12 - PubMed
- PLoS Med. 2009 Jul 21;6(7):e1000100 - PubMed
- Eur Urol. 2002 Jan;41(1):54-60; discussion 60-1 - PubMed
- Int Neurourol J. 2015 Jun;19(2):107-12 - PubMed
- Korean J Urol. 2011 Apr;52(4):274-8 - PubMed
- Andrologia. 2012 May;44 Suppl 1:791-5 - PubMed
- Lancet. 1991 Jun 15;337(8755):1457-61 - PubMed
- Eur Urol. 2006 Dec;50(6):1292-6; discussion 1297-8 - PubMed
- BJU Int. 2006 Mar;97(3):513-9 - PubMed
- Br J Urol. 1997 Oct;80(4):597-605 - PubMed
- Eur Urol. 2007 Jun;51(6):1717-23 - PubMed
- Drugs. 2002;62(4):633-53 - PubMed
- Cent European J Urol. 2017 Jun 30;70(2):148-153 - PubMed
- Clin Interv Aging. 2015 Jan 17;10:277-86 - PubMed
- Urology. 2002 Feb;59(2):281-6 - PubMed
- Eur Urol. 2000 Apr;37(4):421-7 - PubMed
- Eur Urol. 2003 Jul;44(1):101-5 - PubMed
- BJU Int. 2006 Apr;97 Suppl 2:3-6; discussion 21-2 - PubMed
- J Urol. 2006 Jan;175(1):35-42 - PubMed
- BJU Int. 2008 Apr;101(7):847-52 - PubMed
- Int J Clin Pract. 2014 Apr;68(4):471-7 - PubMed
- Low Urin Tract Symptoms. 2014 Jan;6(1):35-40 - PubMed
- Asian J Urol. 2017 Jul;4(3):148-151 - PubMed
- Eur Urol. 1998 Sep;34(3):169-75 - PubMed
- Urology. 2000 Apr;55(4):540-6 - PubMed
- Aging Male. 2020 Dec;23(5):1432-1439 - PubMed
- BJU Int. 2004 Mar;93(4):605-8 - PubMed
- Drugs. 1993 Mar;45(3):410-29 - PubMed
- J Urol. 2006 Feb;175(2):624-8; discussion 628 - PubMed
- BJU Int. 2004 Apr;93(6):757-62 - PubMed
- Turk J Urol. 2015 Sep;41(3):125-31 - PubMed
- Eur Urol. 1997;31(2):190-8 - PubMed
- J Pharmacol Exp Ther. 1997 Jul;282(1):228-35 - PubMed
- BJU Int. 2015 Apr;115(4):508-19 - PubMed
- Evid Based Med. 2016 Aug;21(4):125-7 - PubMed
- Gastroenterol Hepatol (N Y). 2012 Jun;8(6):376-83 - PubMed
Publication Types