Efficacy and Safety of Combination Tamsulosin and Dutasteride versus Tamsulosin Monotherapy for Benign Prostatic Hyperplasia: A Meta-Analysis.

Background: We conducted a meta-analysis to compare the efficacy and drug-related adverse events (AEs) of the combination of tamsulosin and dutasteride versus tamsulosin monotherapy for the treatment of benign prostatic hyperplasia (BPH).

Methods: Relevant articles published in PubMed, Embase and Cochrane from 2004 to 2024 were searched and downloaded. These studies were screened following pre-established inclusion criteria, and data were extracted. Review Manager software was used for methodological quality assessment of randomised controlled trials and statistical analysis.

Results: Eight studies containing 8793 patients were included in the meta-analysis. Combined dutasteride and tamsulosin more significantly improved symptoms (mean difference (MD): -1.55; 95% confidence interval (CI): -2.27, -0.84; p < 0.001), increased maximum urine flow (MD: 1.54; 95% CI: 1.18, 1.91; p < 0.001) and decreased prostate volume (MD: -14.42; 95% CI: -20.62, -8.22; p < 0.001) and prostate-specific antigen (MD: -2.32; 95% CI: -3.03, -1.61; p < 0.001) in patients with BPH than tamsulosin monotherapy. The combined drug also reduced the negative effect on patients' living status (MD: -0.68; 95% CI: -1.02, -0.33; p < 0.001), acute urinary retention or BPH-related surgeries (odds ratio (OR): 0.33; 95% CI: 0.25, 0.44; p < 0.001) and clinical progression of BPH (OR: 0.52; 95% CI: 0.44, 0.61; p < 0.001). However, the combination of dutasteride and tamsulosin significantly increased the incidence of drug-related AEs (OR: 2.13; 95% CI: 1.67, 2.73; p < 0.001) in patients with BPH.

Conclusions: In patients with BPH, the combination of dutasteride and tamsulosin is a beneficial treatment option, but the impact on drug-related AEs events needs to be considered on an individual basis.