5-Alpha Reductase Inhibitors for Male Lower Urinary Tract Symptoms: A Cochrane Systematic Review and Meta-Analysis

The Cochrane systematic review and meta-analysis evaluated the efficacy and safety of 5-alpha reductase inhibitors (5ARIs) for treating male lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). The review included 28 studies with a total of 16,142 patients. Results indicated that 5ARIs led to a small reduction in symptom scores compared to placebo (mean difference of -1.5) and had a similar rate of major adverse events. Compared to alpha blockers (ABs), 5ARIs were associated with slightly higher symptom scores but showed a possible reduction in the risk of acute urinary retention and a small reduction in the need for surgical intervention. Overall, 5ARIs may slightly reduce urological symptoms and the risk of acute urinary retention compared to placebo and probably reduce the need for surgical intervention compared to ABs.