Evidence Summary
What is an Evidence Summary?
Key messages from scientific research that's ready to be acted on
Got It, Hide thisIn older people, dutasteride, fesoterodine, and finasteride are recommended for long-term treatment of lower urinary tract symptoms
Oelke M, Becher K, Castro-Diaz D, et al. Appropriateness of oral drugs for long-term treatment of lower urinary tract symptoms in older persons: results of a systematic literature review and international consensus validation process (LUTS-FORTA 2014). Age Ageing. 2015;44:745-55.
Review question
In older people, which drugs are recommended for long-term treatment of lower urinary tract symptoms?
Background
Lower urinary tract symptoms involve the bladder and/or urethra. Symptoms may include the urge to urinate, frequent urination, burning sensation when urinating, cloudy or coloured urine, and pelvic or rectal pain.
Lower urinary tract symptoms can be treated with many drugs.
How the review was done
The researchers did a systematic review based on studies available up to March 2014.
They found 25 studies, including 18 randomized controlled trials. People in the studies were at least 65 years of age and had lower urinary tract symptoms.
Experts independently reviewed these studies and classified each of 14 drugs for use in older people as: Indispensable, Beneficial, Caution, or Avoid.
What the researchers found
Indispensable
No drugs were classified as indispensable (having clear-cut benefits).
Beneficial
Dutasteride, fesoterodine, and finasteride were classified as beneficial (having proven or obvious efficacy).
Caution
Darifenacin, mirabegron, oxybutynin (low dose/extended release), solifenacin, tadalafil, tamsulosin, tolterodine, and trospium were classified as needing caution (having questionable efficacy/safety profiles).
Avoid
Alfuzosin, doxazosin, and oxybutynin (standard dose/immediate release) were classified as to be avoided.
Conclusion
In older people, dutasteride, fesoterodine, and finasteride are recommended for long-term treatment of lower urinary tract symptoms.
Classification of drugs for lower urinary tract symptoms in people 65 years of age or older*
| Classification | Drug name | Number of studies (number of people) | Approximate rate of side effects |
| Indispensable | No drugs identified | – | – |
| Beneficial | Dutasteride | 3 (4430) | 12% |
|
| Fesoterodine | 6 (2511) | 60% |
|
| Finasteride | 2 (3283) | 12% |
| Caution | Darifenacin | 2 (421) | 58% |
|
| Mirabegron | 1 (1183) | 56% |
|
| Oxybutynin (low dose/extended release) | 1 (111) | 65% |
|
| Solifenacin | 2 (1159) | 36% |
|
| Tadalafil | 2 (558) | 26% |
|
| Tamsulosin | 2 (1121) | 37% |
|
| Tolterodine | 3 (643) | 48% |
|
| Trospium | 1 (178) | 47% |
| Avoid | Alfuzosin | 1 (2121) | 6% |
|
| Doxazosin | 1 (341) | 42% |
|
| Oxybutynin (standard dose/immediate release) | 2 (60) | 73% |
Related Topics
Glossary
Studies where people are assigned to one of the treatments purely by chance.
A comprehensive evaluation of the available research evidence on a particular topic.
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