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Advances in Therapy
Published in: Advances in Therapy 1/2019

01-01-2019 | Review

Silodosin: An Update on Efficacy, Safety and Clinical Indications in Urology

Authors: Luca Villa, Paolo Capogrosso, Umberto Capitanio, Alberto Martini, Alberto Briganti, Andrea Salonia, Francesco Montorsi

Published in: Advances in Therapy | Issue 1/2019

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Abstract

Introduction

Silodosin determines smooth muscle relaxation in bladder and prostate tissues, increases bladder blood flow in conditions of chronic bladder ischemia and regulates the activity of transcriptional factors responsible for stromal growth and prostate hyperplasia. Phase III trials have already demonstrated the efficacy and safety of silodosin in the treatment of patients bothered by lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH).

Objective

We aimed to describe the rationality for the use of silodosin and to summarize the current literature on the use of Silodosin for the treatment of LUTS.

Methods

PubMed and Web of Science were queried with the terms: ‘silodosin’ in combination (AND) with the terms ‘lower urinary tract symptoms’, ‘LUTS’, ‘pathophysiology’, ‘symptoms’ OR ‘therapy’. Studies published in the last 10 years (2007–2017) in adults and core clinical journals in English were included.

Results

Silodosin 8 mg once-daily was superior to placebo in improving IPSS total score, voiding subscore, storage subscore and QoL score, and at least as effective as tamsulosin 0.4 mg once-daily in all the efficacy analyses. In addition, studies assessing the effect on urodynamic parameters showed that silodosin determined a higher improvement in the bladder outlet obstruction index compared to other alpha1 adrenergic receptor antagonists. Concerning the safety profile, long-term data (after 9 months of treatment) confirmed the limited effect of silodosin on the cardiovascular and gastrointestinal systems. Although ejaculatory disorders represented the main complaint of patients taking silodosin, the discontinuation rate due to this condition remained low even in a long-term follow-up study (7.5%). Encouraging findings showed that silodosin may be administered as a medical expulsive therapy for promoting spontaneous stone passage of distal ureteral stones < 10 mm, to relieve LUTS in patients who underwent prostate cancer brachytherapy and to increase the likelihood of successful trials without a catheter in patients experiencing acute urinary retention.

Conclusion

Silodosin is one of the drugs approved for the treatment of BPH, being highly effective in improving not only LUTS but also urodynamic parameter impairments secondary to BPH. Moreover, it has shown efficacy as medical expulsive therapy for distal ureteral stones in previous prospective randomized trials.

Funding

Sponsorship for this study and article processing charges were funded by Recordati.
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Metadata
Title
Silodosin: An Update on Efficacy, Safety and Clinical Indications in Urology
Authors
Luca Villa
Paolo Capogrosso
Umberto Capitanio
Alberto Martini
Alberto Briganti
Andrea Salonia
Francesco Montorsi
Publication date
01-01-2019
Publisher
Springer Healthcare
Published in
Advances in Therapy / Issue 1/2019
Print ISSN: 0741-238X
Electronic ISSN: 1865-8652
DOI
https://doi.org/10.1007/s12325-018-0854-2

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