CONTEXT<\/strong> Chronic prostatitis\/chronic pelvic pain syndrome (CP\/CPPS) is common, but trial evidence is conflicting and therapeutic options are controversial.<\/p>\n\n\n\n OBJECTIVE <\/strong>To conduct a systematic review and network meta-analysis comparing mean symptom scores and treatment response among \u03b1-blockers, antibiotics, anti-inflammatory drugs, other active drugs (phytotherapy, glycosaminoglycans, finasteride, and neuromodulators), and placebo.<\/p>\n\n\n\n DATA SOURCES<\/strong> We searched MEDLINE from 1949 and EMBASE from 1974 to November 16, 2010, using the PubMed and Ovid search engines. STUDY SELECTIONRandomized controlled trials comparing drug treatments in CP\/CPPS patients.<\/p>\n\n\n\n DATA EXTRACTION <\/strong>Two reviewers independently extracted mean symptom scores, quality-of-life measures, and response to treatment between treatment groups. Standardized mean difference and random-effects methods were applied for pooling continuous and dichotomous outcomes, respectively. A longitudinal mixed regression model was used for network meta-analysis to indirectly compare treatment effects.<\/p>\n\n\n\n DATA SYNTHESIS <\/strong>Twenty-three of 262 studies identified were eligible. Compared with placebo, \u03b1-blockers were associated with significant improvement in symptoms with standardized mean differences in total symptom, pain, voiding, and quality-of-life scores of -1.7 (95% confidence interval [CI], -2.8 to -0.6), -1.1 (95% CI, -1.8 to -0.3), -1.4 (95% CI, -2.3 to -0.5), and -1.0 (95% CI, -1.8 to -0.2), respectively. Patients receiving \u03b1-blockers or anti-inflammatory medications had a higher chance of favorable response compared with placebo, with pooled RRs of 1.6 (95% CI, 1.1-2.3) and 1.8 (95% CI, 1.2-2.6), respectively. Contour-enhanced funnel plots suggested the presence of publication bias for smaller studies of \u03b1-blocker therapies. The network meta-analysis suggested benefits of antibiotics in decreasing total symptom scores (-9.8; 95% CI, -15.1 to -4.6), pain scores (-4.4; 95% CI, -7.0 to -1.9), voiding scores (-2.8; 95% CI, -4.1 to -1.6), and quality-of-life scores (-1.9; 95% CI, -3.6 to -0.2) compared with placebo. Combining \u03b1-blockers and antibiotics yielded the greatest benefits compared with placebo, with corresponding decreases of -13.8 (95% CI, -17.5 to -10.2) for total symptom scores, -5.7 (95% CI, -7.8 to -3.6) for pain scores, -3.7 (95% CI, -5.2 to -2.1) for voiding, and -2.8 (95% CI, -4.7 to -0.9) for quality-of-life scores.<\/p>\n\n\n\n CONCLUSIONS <\/strong>\u03b1-Blockers, antibiotics, and combinations of these therapies appear to achieve the greatest improvement in clinical symptom scores compared with placebo. Anti-inflammatory therapies have a lesser but measurable benefit on selected outcomes. However, beneficial effects of \u03b1-blockers may be overestimated because of publication bias.<\/p>\n","protected":false},"excerpt":{"rendered":" nothaisintawee T, Attia J, Nickel JC, Thammakraisorn S, Numthavaj P, McEvoy M, Thakkinstian A; Journal of the American Medical Association (JAMA) 305 (1), 78-86 (Jan 2011) CONTEXT Chronic prostatitis\/chronic pelvic pain syndrome (CP\/CPPS) is common, but trial evidence is conflicting and therapeutic options are controversial. OBJECTIVE To conduct a systematic review and network meta-analysis comparing […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"off","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[186,191],"tags":[],"class_list":["post-5786","post","type-post","status-publish","format-standard","hentry","category-186","category-191"],"_links":{"self":[{"href":"https:\/\/e-algos.com\/el\/wp-json\/wp\/v2\/posts\/5786","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/e-algos.com\/el\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/e-algos.com\/el\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/e-algos.com\/el\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/e-algos.com\/el\/wp-json\/wp\/v2\/comments?post=5786"}],"version-history":[{"count":1,"href":"https:\/\/e-algos.com\/el\/wp-json\/wp\/v2\/posts\/5786\/revisions"}],"predecessor-version":[{"id":5787,"href":"https:\/\/e-algos.com\/el\/wp-json\/wp\/v2\/posts\/5786\/revisions\/5787"}],"wp:attachment":[{"href":"https:\/\/e-algos.com\/el\/wp-json\/wp\/v2\/media?parent=5786"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/e-algos.com\/el\/wp-json\/wp\/v2\/categories?post=5786"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/e-algos.com\/el\/wp-json\/wp\/v2\/tags?post=5786"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}